OPEN DIVISON SESSIONAL PROGRAM

BOYS CAN DANCE

FREE CLASS

Boys Ages 6 to 9

We are passionate about creating a safe environment for boys and offering accessible training for those wanting to explore an interest in dance. Students in Boys Can Dance will be taught by a male instructor who is under the leadership of Andrew Pronger, School Principal and former professional dancer with Queensland Ballet.

Boys Can Dance is a ballet/jazz fusion class and will explore strength, coordination, and rhythm in a fun and comfortable environment.

*Students must be the listed age as of September 2023. Spaces are limited.

SCHEDULE

TERM 3: April 2 – June 2, 2024

> Saturday 2:45PM – 3:30PM

UNIFORMS

LEARN MORE ABOUT UNIFORMS

REGISTRATION

Program SelectionStep 1 of 7

Program Selection *

Session 3: Boys Can Dance - Saturday | Ages 6-9

We are looking for Host Families! Victoria Academy of Ballet hosts students from around the world for 2 weeks up to 11 months of the year. Host Families provide a caring and supportive environment, while receiving monthly remuneration and experiencing the dance world first-hand. Are you interested in becoming a Host Family or receiving more information about becoming a Host Family?

Student Status: *

How did you learn about VAB? *

A Friend or Family Member
Social Media
Print Ad or Directory Listing
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Student First Name *

Student Preferred Name (if applicable)

Student Last Name *

Student Age *

*PLEASE NOTE: Your student must be the listed age as of January 1st, 2023. Thank you!

Student Date of Birth *

*PLEASE NOTE: Your student must be the listed age as of January 1st, 2023. Thank you!

Student Gender *

Student Pronouns *

Example: She/Her, He/Him, They/Them

Medical Conditions or Allergies

Please include any important medical conditions or allergies that would be important for VAB to know.

Current Medications

Please include any current medications your student is on and that VAB should be aware of.

Musculoskeletal Injuries (Past or Present)

Please include any musculoskeletal (muscle or bone) injuries.

I have chosen to vaccinate my child: *

MEDICAL INSURANCE IS MANDATORY IN CANADA and mandatory for participation in Victoria Academy of Ballet (“VAB”) programs. Participants in VAB programs, or their guardians, must assume the risk of injury associated with participation in rigorous physical activity programs, including but not limited to slips, falls, incidental contact, and any injuries, damage, and expenses resulting therefrom. By participating in a VAB program, I hereby assume said risk and release VAB and its officers, directors, employees, contractors, agents, students, host families, affiliates, and assigns from liability for injury, damage, medical expenses, other expenses, and costs, however arising. All students are responsible for ensuring that they have and maintain medical coverage either with British Columbia or their home province. *

I Agree

Student Personal Health Care Number *

Province where Personal Health Care Number was issued *

State / Province / Region

I authorize VAB or its representative to authorize necessary medical treatment for me if I am unable to give authorization and consent at the time. If under the age of 19, the parent and/or guardian cannot be contacted or reached in a timely manner to authorize medical treatment, I hereby authorize VAB or its representative to authorize necessary medical treatment where such treatment is recommended by hospital staff or a physician. *

I Agree

If there are treatments which I am not willing to authorize under any, including potentially fatal, circumstances, those treatments are:

If VAB authorizes treatment under the foregoing authorization, I hereby release, on my own behalf and/or on behalf of the program participant of whom I am the legal guardian, VAB and its officers, directors, employees, contractors, agents, students, host families, affiliates, and assigns from liability for injury, damage, medical expenses, other expenses, and costs, however arising. This authorization and release shall be valid for the full duration of the student's participation in any Victoria Academy of Ballet program. *

I Agree

PRIMARY PARENT/GUARDIAN

Primary Parent/Guardian First Name *

Primary Parent/Guardian Last Name *

Primary Parent/Guardian Address *

Address Line 1

City

State / Province / Region

Zip / Postal Code

Country

Primary Parent/Guardian Cell Phone *

Primary Parent/Guardian Home Phone

Primary Parent/Guardian Email *

*The primary parent/guardian email will be the email kept on file. We rely heavily on email communications so please ensure this information is correct.

SECONDARY PARENT/GUARDIAN

Secondary Parent/Guardian First Name

Secondary Parent/Guardian Last Name

Secondary Parent/Guardian Address

Address Line 1

City

State / Province / Region

Zip / Postal Code

Country

Secondary Parent/Guardian Email

Secondary Parent/Guardian Phone

*Emergency contact must NOT be the primary parent/guardian. Please list another contact for emergency purposes.

Emergency Contact First Name *

Emergency Contact Last Name *

Emergency Contact Phone *

Emergency Contact Relation to Student *

I will be ordering uniforms through VAB *

*Please note: A separate uniform order link will be provided at a later date.

AGREEMENTS

By agreeing to this Application, we hereby attest to the accuracy of the information provided herein, and agree to all terms and releases and give all authorizations contained herein. *

I Agree

Date of Agreements: *

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OPEN DIVISON SESSIONAL PROGRAM

BOYS CAN DANCE

FREE CLASS

Boys Ages 6 to 9

SCHEDULE

TERM 3: April 2 – June 2, 2024

> Saturday 2:45PM – 3:30PM

UNIFORMS

REGISTRATION

PRIMARY PARENT/GUARDIAN

SECONDARY PARENT/GUARDIAN

AGREEMENTS

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