Name Dance group or school. Address

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1 REGISTRATION for XV Folk Dance Festival Instructors Workshop REGISTRACIJA XV Šokių Šventės Mokytojų Kursams Aug. 9-16, 2015 Name Dance group or school Address Phone Dates attending Transportation* All week Other; please specify dates: I m looking for transportation from the Detroit airport I m looking for transportation to the Detroit airport Arrival/departure details: Vardas Sokiu Grupe/Mokykla Adresas Telefonas Lankymo Datos Transportacija* Visa savaite Kitaip; parasyk datas: Jieskau transporto is Detroito oro uosto Jieskau transporto i Detroito oro uosto Atvykimo/Isvaziavimo detales: Important information The XV Lithuanian Folk Dance Festival Instructors Dance Workshop will be held at Camp Dainava in Manchester Michigan. All participants must complete all registration materials and submit appropriate fees. Participation is strictly limited to adults of age 18 and up. The Lithuanian Folk Dance Institute officers reserve the right to require any person not complying with these requirements to leave the premises of Camp Dainava. Svarbi informacija The XV Lietuvių Tautinių Šokių Švente Mokytoju Kursai vyks Dainavos stovyloje Manchester, Mičigano valstijoje. Visi dalyviai turi užpildyti visus registracijos medžiagą ir pateikti atitinkamus mokesčius. Dalyvavimas yra griežtai apribotas suaugusiems nuo 18 ir daugiau. Lietuvių Tautinių Šokių Instituto pareigūnai pasilieka teisę reikalauti bet kuris asmuo, neatitinkantys šių reikalavimų palikti Dainvos patalpas.

2 Instructions for each attendee Please submit this form, the attached consent record form, and appropriate registration and participation fees. Please note the registration deadline of Friday July 31. Please send all registration materials and payments (made out to Lithuanian Folk Dance Institute) to: Dalyvio Nurodymai Prašome pateikti šią formą, pridėtą sutikimo registracijos formą, ir atitinkamus registracijos ir dalyvio mokesčius. Atkreipkite dėmesį, kad registracijos baigiasi, penktadienį liepos 31d. Prašome siųsti visus registracijos medžiagas ir mokėjimus (čekius rašyti Lithuanian Folk Dance Institute): Vilija Kirvelaitis Freedom St. South Riding, VA Fees Due to a generous grant from the Lithuanian Foundation (Lietuvių Fondas), we are pleased to be able to offer significantly reduced participation fees this year. Mokesčiai Lietuvių Fondo dosnumu, džiaugiamės kad galime gali pasiūlyti žymiai mažesne dalyvio mokesčius šiais metais. Full week: teachers and dancers who prie-registered with $40 $40 + $100 = $140 deposit by June 15, 2015 total Full-week: teachers and dancers $160 Daily rate: teachers and dancers $30 Children under 12 (accompanied by parents) 50% discount Full-week rate: other adults $250 Daily rate: other adults $50 T-SHIRT INFORMATION Gender Size Color Please indicate: M or W S M L XL Gray/Blue ADDITIONAL INFORMATION Registration and participation fees include room and board and workshop materials. Camp Dainava facilities provide twin-size beds and pillows. All participants are responsible for bringing sheets or sleeping bags and pillow covers. Towels and toiletries are not provided. *The organizers will attempt to assist in arranging transportation to and from the Detroit airport where possible for participants. We ask that you contact us with the information as soon as possible. Please contact the LTSI officers for details.

3 PAPILDOMA INFORMACIJA Registracijos ir dalyvavimo mokesčiai yra skiriami del, nakvynes, maista ir seminaro medžiagas. Dainavos Stovykla bus parūpintos lovos ir pagalvės. Visi dalyviai yra atsakingi atsivezti paklodę čiužiniui, miegmaišį ir užvalkalą pagalvei. Tuo paciu atvežkite, rankšluosčius ir tualetinius reikmenius. * Organizatoriai bandys padėti sukoordinuoti transporta iš Detroito oro uosto kur įmanoma kursantų dalyviam. Mes tik reikalaujame kad praneštumėt ko anksčiau. Prašome susisiekti su LTSI komiteto su detalėm. DRIVING DIRECTIONS FROM: Detroit Metropolitan Airport TO: Camp Dainava W Austin Rd Manchester, MI Take I-94 W to Chicago (37.2 mi) 2. Take exit 159 to merge onto M-52 S/Chelsea Manchester Rd toward Manchester 3. Continue to follow M-52 S (10.9 mi) 4. Turn right onto E Main St (0.8 mi) 5. Continue onto W Austin Rd, destination will be on the left (4.0 mi) IMPORTANT REMINDERS It is mandatory that each group planning to participate in the Dance Festival have their director, or at least one teacher or other representative, participate. Please contact the artistic director, Tomas Mikuckis, mikuckis@gmail.com, and the registration coordinator, Vilija Kirvelaitis, vkirvelaitis@hotmail.com, with any questions or concerns. Reikalaujame kad kiekvienos grupės vadovas, ar bent vienas mokytojas ar kitas atsovas, dalyvautų šokiu kursuose. Prašome parašyti meno vadovui, Tomui Mikuckiui, Mikuckis@gmail.com, ir registracijos koordinatorei, Vilijai Kirvelaitienei, vkirvelaitis@hotmail.com, jei turite klausimų.

4 ADDITIONAL INFORMATION FOR ALL DANCE GROUP DIRECTORS: SECOND ROUND DANCE GROUP REGISTRATION FOR XV LITHUANIAN FOLK DANCE FESTIVAL / ANTRA GRUPIŲ REGISTRACIJA XV TAUTINIŲ ŠOKIŲ ŠVENTEI We are requesting that each dance instructor bring the below completed XV Dance Festival registratoin form, which is also mandatory to be completed by the Dance Course for participation in the festival. We understand that there may be changes in the fall, but it is critical for us to know as early as possible approximately how many dancers will be participating in the festival. Prašome kad kiekvienas vadovas atsivežtų į kursus šį antra XV Šokių Šventės registracijos lapą, kuris yra taip pat reikalaujamas dalyvauti šventėje. Suprantame kad gali būti pasikeitimų, bet mums svarbu kuo ankščiau pradėti suprasti kiek grupių dalyvaus šventėje. Grupės Vardas / Group Grupės Miestas / Group City: Grupės Vadovas / Director: Šokėjų amžius Dancers age Kiek Šokėjų pagal ratelį? Number of dancers per age group participating Kiek grupiu užregistruojate šokių šventėje? Number of groups / circles registered for the festival? Vaikai (Children) (7)/8 years 6 th grade Jauniai (Youth) 7 th -11 th grade Studentai (Student) 12 th grade - college Pagyvene (Adult) Up to 45years old Veteranai (Veteran) 45+ years old

5 EF. PROCEDURE: Rule 117.2, 117.3, CONSENT RECORD This form MUST be signed by any person participating in any camping activity at Camp Dainava. This includes camps sponsored by the Lithuanian Catholic Federation Ateitis, Lithuanian Scout Association and others. ***Indicates information that must be provided. Participant s Name(Last) First Middle Sex Date of Birth Address(Number and Street) City State Zip Telephone(Home) Medical Insurance Co. Date of Arrival*** Insurance Policy and Subscriber No. Date of Departure*** Persons to be notified in an Emergency situation: Telephone Number: Telephone Number: Names of persons other than authorized person to whom participant may be released: Participant s special needs, limitations, and required adaptations: I understand, agree and acknowledge that Camp Dainava, and any sponsoring organization and/or their respective directors, officers, employees or volunteers cannot assume any responsibility for an injury, damage or harm which might result during the course of any activity during the camp or traveling to or from such activity and shall not be liable for any claim or lawsuit arising out of any such injury, damage or harm. In consideration of permitting participation in any organized camp, I agree that such responsibility for myself. Should any claim be asserted by any person as the result of the my acts while participating in any activity during camp activities or traveling to or from such activity or should I assert any claim or lawsuit against any organization, Camp Dainava or any sponsoring organization and/or their respective directors, officers, employees or volunteers, I agree to indemnify and hold any sponsoring organization, Camp Dainava and their respective directors, officers, employees and volunteers harmless from any such claim or lawsuit, including attorney s fees and costs incurred in defense thereof. I further authorize medical treatment in the event of illness or injury sustained while participating in the activities at Camp Dainava. Signature of participant Signature: Address: Date:

Session 1: Session 2: Session 3: Session 4: Session 5: Session 6: Session 7: Session 8: Session 9:

Session 1: Session 2: Session 3: Session 4: Session 5: Session 6: Session 7: Session 8: Session 9: 2017 7480 Narcoossee Road, Suite 100A-E Orlando, Florida 32822 407-826-1994 www.upmafc.com Name of Camper: Date of Registration: Registration Fee/Deposit: SUMMER CAMP SESSIONS: (Please check session that