Students will not be allowed to participate in the clinics or tryouts unless all paperwork has been submitted by April 4, 2017.

Transcription

1 TRYOUT PACKET CHECKLIST 2017 First Middle Last Grade (upcoming year) Date (X) Required Docs Pre-registration REQUIRED student name and upcoming grade to Dance Coach Carla Jackson-Tucker at Permission Form 4x6 Headshot (attach to checklist cover page) Dancer Application Team Captain Application (8 th grade ONLY). Skip if 6 th or 7 th grade. After School Athletic Participation Forms Financial Information Photo Release Form Current Grade Report Students will not be allowed to participate in the clinics or tryouts unless all paperwork has been submitted by April 4, 2017.

2 PERMISSION FORM 2017 First Middle Last Grade (upcoming year) Date has my permission to participate in the dance clinics and tryouts for the Cooley Dance Team on April 4-7, I understand that there are grade and conduct requirements. Failure to maintain the requirements can result in temporary probation. I further understand that there are no required fees to participate in the dance team. However, tryouts are required and not all students will make the team. Uniforms, shoes, and other costs associated with the team will only be ordered if enough parent donations and/or fundraising dollars are earned or sponsorships are received. All funds received will benefit the entire team. *** Participants MUST be covered by a PRIVATE INSURANCE POLICY. Please refer to the After School Athletic Participation Form to complete the required insurance information. PRINT Mother s Full PRINT Father s Full Mother Signature Father Signature If I am selected as a member of the Cooley Dance Team, my parent(s) or guardian(s) and I will agree to the above guidelines. Student Signature

3 DANCER APPLICATION 2017 Student Information Address Home Phone Cell Phone Birth Date Grade (upcoming year) Parent/Guardian Information Cell Phone Parent/Guardian Information Cell Phone

4 Please answer the following four questions truthfully and to the best of your ability. Question 1 Do you have dance experience? If yes, please explain. Question 2 Why do you want to be on the Cooley Dance Team? Question 3 Do you play any sports or engage in any other activities that might conflict with dance practice? If so, how do you see yourself balancing these responsibilities with the Cooley Dance Team? Question 4 Is there anything else about yourself that you would like to share? (Examples: tumbling skills, hobbies, special talents, etc).

5 Question 5 8 th grade ONLY (skip if 6 th or 7 th grade) Are you interested in being a team Captain or Lieutenant? If yes, please complete the Team Captain Application on the next page and submit it with your packet. YES NO N/A (6 th or 7 th grade) (Student only) Please initial if you certify that all the information you have provided in this application/packet is true. If any of the information provided is untrue, it will be grounds for removal from tryouts and/or the dance team. Thank you Student Signature Date Parent/Guardian (please print) Parent/Guardian Signature

6 TEAM CAPTAIN/LIEUTENANT APPLICATION 2017 (8 th grade ONLY) The dance coach will be selecting a team of Officers to help lead the Dance Team for the 2017 season. At least one team Captain and one Lieutenant will be chosen, with the possibility of up to two each (4 total officers). If you will be an 8 th grader and are interested in helping to lead the team, please review the roles below and answer the following questions. What is the role of a Captain on the Cooley Dance Team? Team captains report directly to the dance coach and are expected to set an example for the dance team. If selected as a team captain, you will be seen as a leader on the team and a student ambassador. Team captains are held to a higher standard than their teammates and are therefore required to be at all team practices and performances (see team handbook for exceptions), as well as maintain a high academic grade level. What is the role of a Lieutenant on the Cooley Dance Team? Lieutenants report directly to the dance coach. Just as captains are expected to set an example for the dance team, so are lieutenants. If selected as a lieutenant, you will be seen as a leader and student ambassador. Lieutenants are held to a higher standard than their teammates and are required to be at all team practices and performances (see team handbook for exceptions), as well as maintain a high academic grade level. Their primary role is to provide support to the coach and captains as needed. In the event that the captains are unavailable, the lieutenant is expected to fulfill that role until the captain returns.

7 Question 1 Team Captains and Lieutenants are seen as leaders of a group. It is critical that they be at ALL team practices and performances. Can you make this type of commitment? Please explain. Question 2 If you see a fellow dance teammate struggling with choreography, what would you do? Question 3 Coach Carla will often need help with various tasks such as warm-ups, choreography, setup, cleanup, running music, etc. In what other ways do you think you can assist the team coach? Question 4 Is there anything else you would like Coach Carla to know about you? Thank you for your interest in being a Dance Team Captain! Coach Carla will select a leadership team by April 19, 2017.

8 AFTER SCHOOL ATHLETIC PARTICIPATION CLEARANCE FORM (page 1 of 2) 2017 I hereby give permission for my daughter/son to tryout, practice and participate in the Roseville City School District (RCSD) After School Athletic Program. I recognize that these activities may require strenuous physical exertion and I believe that my child is physically able to participate without damage to her/his health. I release the RCSD from any liability arising from any such physical activities. I understand, acknowledge, and agree that the RCSD, its employees, officers, agents, or volunteers, shall not be liable for any injury suffered by my daughter/son which is incident to and/or associated with the preparing for and/or participating is this activity. In case of accident or other emergency if a parent/guardian cannot be reached, I hereby authorize a representative of the of the school to make such arrangements as she/he considers necessary for my child to receive medical or hospital care, including transportation. Under such circumstances, I further authorize the physician named below to undertake such care and treatment of my child, as she/he considers necessary. In the event that said doctor is not available, I authorize such care and treatment to be performed by any licensed physician or surgeon. The undersigned hereby agrees to bear all costs incurred as a result of the foregoing. SPECIAL INSURANCE NOTICE California Education Code requires that any student of any "educational institution" who participates in any athletic event MUST BE INSURED FOR A MINIMUM OF $1, covering the medical expenses of accident injuries. Students are not allowed to participate in athletic events until adequate insurance is in force, which meets the requirements of this law. The information you fill out below indicates that your family coverage meets the requirements of the law.

9 AFTER SCHOOL ATHLETIC PARTICIPATION CLEARANCE FORM (page 2 of 2) 2017 Student Information Last First Middle Birthdate Grade Address City Zip Home Phone Parent/Guardian Information Father First Last Employer Work Phone Cell Phone Mother First Last Employer Work Phone Cell Phone Family Physician/Medical Advisor Phone of Health Plan Group or Policy Number Phone EMERGENCY CONTACT INFORMATION - Persons who may act for parents when parents cannot be reached. & Relationship to Student Address City Zip Phone & Relationship to Student Address City Zip Phone Medical Information: Does your child have any health conditions/allergies/or other which could require emergency medical care? If so, please explain. Is your child on any regular medication? If so, please list below. PLEASE NOTE THAT PARTICIPATION WILL NOT BE ALLOWED UNTIL ADEQUATE COVERAGE IS PROVIDED. IF YOUR INSURANCE CHANGES OR IS DISCOUNTINUED, IT IS YOUR RESPONSIBILITY TO NOTIFY THE SCHOOL IMMEDIATELY. I ACKNOWLEDGE THAT I HAVE CAREFULLY READ THIS FORM AND UNDERSTAND AND AGREE TO ITS TERMS. Parent Signature Student Signature Date

10 FINANCIAL INFORMATION 2017 As a member of the Dance Team at Cooley Middle School, each family will be responsible for group fundraising efforts so that we can defray costs associated with uniforms, warm-ups, shoes, dance camp, etc. * Cooley Middle School does not want cost to prohibit anyone from trying out for the dance team. Therefore, fees are not required to join the team. HOWEVER, we welcome individual donations as well as sponsorships, and we expect that each family will do their part to defray uniform expenses. These items are tax-deductible and all monies received will benefit the entire team. If we do not raise enough money for uniforms, they cannot be ordered. ** We are excited to announce that Cooley Dance Team will participate in the 2017 United Spirit Association (USA) Summer Camp! At this stage, we are still deciding whether or not to have a home camp (July 17-19) or to travel off campus like we did last year. If we travel offsite, we will either commute each day or spend the night. Camp will be held at California State University, Sacramento from July INDOOR FACILITIES THIS YEAR!! While we cannot make camp mandatory, camp helps set the foundation for the team and the season ahead. Students use this time to bond and establish friendships, learn choreography (at least 3-4 routines each), set goals for the year, build rapport with Coach Carla, and much more.

11 NEW Dancers ONLY (returning dancers continue to next page) Registration / Uniforms Fees * Check or cash only. Please make checks payable to Cooley Middle School Donations $ $ (Boys) Due Date USA Individual Camp Fee April 19 or Payment Options (see schedule below) $ (overnight) OR $ (commute) * Donations of $140 must be submitted on April 19 or by May 5 (We will fundraise for the remaining balance) 1 Custom T-Shirt FREE 1 Pair of Tights FREE TOTAL Includes Camp Overnight Fee TOTAL Includes Camp Commute Fee TOTAL Includes partial camp Fee $ $ (boys) $ $ (boys) $ $ (boys) Uniform: 1. Jersey (performance top) 2. Tank Top (warm-up top) / T-shirt (boys only) 3. Leggings/Pants (performance bottoms) 4. Sweats (warm-up bottoms) 5. Shorts (performance bottoms) 6. Tights 7. Jacket 8. Duffle Bag / Backpack (boys only) 9. 1 pair of sneakers pair of jazz shoes pair of white Keds (not included in fee need to purchase separately) OPTIONAL Payment Schedule (Based only on total with partial camp fee IF selecting to pay the complete total upfront, please divide amounts in half and submit according to due dates) Donation 1 $ Due April 19, 2017; Boys - $ Donation 2 (final balance) $ Due May 5, 2017; Boys - $207.50

12 RETURNING Dancers ONLY --- Option 1 of 2 (IF NEW UNIFORMS PIECES ARE NEEDED) --- Registration / Uniform Fees * Check or cash only. Please make checks payable to Cooley Middle School Donations/Sponsorships $ $ (Boys) Due Date USA Individual Camp Fee April 19 or Payment Options (see schedule below) $ (overnight) OR $ (commute) * Donations of $140 must be submitted on April 19 or by May 5 (We will fundraise for the remaining balance) 1 Custom T-Shirt FREE 1 Pair of Tights FREE TOTAL Includes Camp Overnight Fee TOTAL Includes Camp Commute Fee TOTAL Includes partial camp Fee $ $ (boys) $ $ (boys) $ $ (boys) * NEW THIS YEAR: Jersey s and sweats will be replaced with a new style. If your student needs to replace ANY of their other uniform pieces (as noted below), please list the item(s) [excluding shoes & tights]. Uniform pieces can only be replaced if we receive enough donations or fundraising dollars. Uniform: 1. Jersey (performance top) 2. Tank Top (warm-up top) / T-shirt (boys only) 3. Leggings/Pants (performance bottoms) 4. Sweats (warm-up bottoms) 5. Shorts (performance bottoms) 6. Tights 7. Jacket 8. Duffle Bag / Backpack (boys only) 9. 1 pair of sneakers pair of jazz shoes pair of white Keds (not included in fee need to purchase separately) * List replacement item(s) here: - Coach Carla will contact you to get the correct size(s) before placing the order. OPTIONAL Payment Schedule (Based only on total with partial camp fee IF selecting to pay the complete total upfront, please divide amounts in half and submit according to due dates) Donation 1 $ Due April 19, 2017; Boys - $ Donation 2 (final balance) $ Due May 5, 2017; Boys - $147.50

13 RETURNING Dancers ONLY --- Option 2 of 2 (IF NEW UNIFORMS ARE NOT NEEDED) --- [with the exception of the new jersey style and sweats] Registration / Uniform Fees * Check or cash only. Please make checks payable to Cooley Middle School Donations/Sponsorships $ $ (Boys) Due Date USA Individual Camp Fee April 19 or Payment Options (see schedule below) $ (overnight) OR $ (commute) * Donations of $140 must be submitted on April 19 or by May 5 (We will fundraise for the remaining balance) 1 Custom T-Shirt FREE 1 Pair of Tights FREE TOTAL Includes Camp Overnight Fee TOTAL Includes Camp Commute Fee TOTAL Includes partial camp Fee $ $ (boys) $ $ (boys) $ $ (boys) * NEW THIS YEAR: Jersey s and sweats will be replaced with a new style. If your student DOES NOT need to replace any of their other uniform items (as noted below), [excluding shoes & tights], YOU ARE ALL SET! Uniform: 1. Jersey (performance top) 2. Tank Top (warm-up top) / T-shirt (boys only) 3. Leggings/Pants (performance bottoms) 4. Sweats (warm-up bottoms) 5. Shorts (performance bottoms) 6. Tights 7. Jacket 8. Duffle Bag / Backpack (boys only) 9. 1 pair of sneakers pair of jazz shoes pair of white Keds (not included in fee need to purchase separately) OPTIONAL Payment Schedule (Based only on total with partial camp fee IF selecting to pay the complete total upfront, please divide amounts in half and submit according to due dates) Donation 1 $ Due April 19, 2017; Boys - $ Donation 2 (final balance) $ Due May 5, 2017; Boys - $138.75

14 Thank you for your commitment to the Cooley Dance Team! Please sign that you are agree to the following: I understand that there will be NO REFUNDS of any kind after donations and/or sponsorships have been received. I understand that funds received for this program will be used at the discretion of Coach Carla and the Cooley Athletic Director. I understand that funds raised by the dance team will be used for the team at the discretion of Coach Carla and the Cooley Athletic Director. Parent Signature Date

15 PHOTO RELEASE FORM 2017 Members of the Cooley Middle School Dance Team will be photographed as soon as they make the team. Photographs might also be taken during tryouts. Once the official team is announced, photographs of team members could be posted on the team website, the school website, the Roseville City School District website, social media accounts such as Instagram, and printed materials that would be distributed around campus and/or offsite when fundraising. Please sign below if you authorize the CMS Dance Team to use photos and videos of your student for promotional purposes only. Parent Signature Date