NURU Dance Camp Sign Up form

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The Nuru Dance Academy is a vibrant co-ed group that meets weekly to learn new dance techniques and choreography. Participants, ranging from ages 3 to 17, engage in joyful and expressive performances at various events such as the African Festival, the Ballet Festival, and more!

Interested in signing up a child for NURU Dance?
Kindly fill this form and we will be in touch.

More info: lesclay.org/nuru

Camp Dates & Times: 10 am to 3 pm. Aug 5-9

Address: 1258 MADISON AVE GRAND RAPIDS MI 12345

cost: $100 per child but don't let that scare you (scholarships available).

WHICH INCLUDES:

. Lunch: Enjoy a delicious meal with fellow attendees.

• Transportation: Convenient round-trip transportation provided.

• Shirts: Receive a stylish event t-shirt.

• Professional Experience: Gain invaluable insights from industry leaders.

• Networking Opportunities: Build connections that could shape your career

AnnLusamba@lesclay.org or Daniellatshibangu@lesclay.org

Parent/ guardian name? *

Parent/ guardian cell phone number *

Parent/ guardian email
*

What is your home address? *

Child's name? *

Child's date of birth?

YYYY

Child's grade (2024-25)

Camp fee *

I can afford it

I'll need assistance with the fee. I can pay for part of it

I'll need assistance with the fee. I cannot contribute at this time

Does the child have sibling in the program?

Yes

Clear selection

Other sibling name

I grant Les Clay my permission to use the photographs and videos of my child taken during any Nuru event for any legal use, including but not limited to: publicity, copyright purposes, illustration, advertising, and web content. Furthermore, I understand that no royalty, fee or other compensation shall become payable to me by reason of such use.
*

Agree

Disagree

Required

In the event of an emergency, I give permission to transport my child to a hospital for emergency medical or surgical treatment. I wish to be advised prior to any further treatment by the hospital or doctor. In the event of an emergency and you are unable to reach me at the above numbers, contact:

You should be aware of these special medical conditions of my child:

Name of Parent of guardian
*

Sign with initials

Submit

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