Iowa State Dance Team Prep Clinic (Fall 2024)

DANCE-CLINIC-FALL-2024

Sunday, September 29, 2024
12:00 to 5:00 pm
Sukup Basketball Practice Facility

This clinic will be offered to anyone in 8th grade through college that are interested in learning what it takes to dance at the college level and specifically at Iowa State University. With registration, participants will have the chance to learn skills in leaps, turns, jumps, pom/game day material, as well as a jazz/hip hop dance from the current Iowa State Dance Team members and coaches.

Cost is $60 per participant and will be accepted through the day of the clinic.

A current athletic physical examination completed within one year of the clinic and the Participation Agreement must be provided in order to participate. Please see below for the Participation Agreement. For more information: email Jill Petersen

Participant Information Please tell us who will be participating in this clinic.

First Name:	First Name is required.
Last Name:	Last Name is required.
Address:	Address is required.
City:	City is required.
State:	State is required.
Zip Code:	Zip Code is required.
Participant Phone Number:	Phone Address is required.
Participant E-mail Address:	Email Address is required.
Preferred E-mail Address for Clinic Information (Parent or Participant):

Participant Background Tell us a little bit about the background and abilities of the participant.

Current School (High School or College):	Current School is required.
Current Grade Classification:

Emergency Contact Please provide emergency contact information for the participant.

Name of Emergency Contact:	Name of Emergency Contact is required.
Relation to Participant:	Relation to Participant is required.
Phone Number to Contact in Emergency:

Transportation Participant will be responsible for drop-off and pick-up.

Name of Driver:

Insurance Information Please provide insurance information for the participant.

Policy Holder's Name:	Policy Holder's Name is required.
Policy Holder's Phone Number:
Relation to Participant:	Relation to Participant is required.
Insurance Company Name:	Insurance Company Name is required.
Insurance Company's Customer Service Number:

Athletic Exam Required for participation in the clinic.

An athletic examination form will need to be prepared and signed by the participant's healthcare provider prior to the start of the clinic. A copy of Iowa State Spirit Squad's athletic exam form can be downloaded here (PDF).

If you have a copy of their current form available in PDF or JPEG format, please upload it at this time.

Participation Agreement and Waiver Review the following. You must agree in order to complete the registration.

IOWA STATE UNIVERSITY OF SCIENCE AND TECHNOLOGY

ISU Athletics Department – Iowa State Dance Team Prep Clinic Participation Agreement,
Parental Permission Agreement, Assumption of Risk, Release of Liability and Emergency Medical Information

PLEASE READ THIS AGREEMENT CAREFULLY. This Agreement must be read and signed by each participant as well as the parent or guardian of each participant under 18 years of age. It is a legal contract and affects any rights you/your child may have if your child is injured or otherwise suffers damages while participating in the Iowa State Dance Team Prep Clinic and related activities.

PROGRAM DESCRIPTION
The Iowa State University Athletics Department is hosting a College Dance Prep Clinic for students in grades 8-12 and college students. ISU Dance Team coaches and dancers will present materials, demonstrate skills and teach participants skills that will help participants prepare for college dance and specifically for ISU Dance Team. This clinic will focus on teaching college game-day material, dance technique/skills required at the college level, as well as style routines.

BEHAVIOR EXPECTATIONS
It is important to follow the directions of the program leader(s) at all times. I understand that, as a participant, I have the responsibility to help make the activity a safe experience for everyone through my behavior and conduct. I also understand the danger of not following rules and directions and agree to follow them.

IMAGE/VOICE PERMISSION
Photographic images or video/audio recordings may be taken of you and/or your child during program activities. Unless you request otherwise, this Agreement will be considered permission for Iowa State University to photograph, film, audio/video tape, record and/or televise your image and/or voice or the image and/or voice of your child/children for use in any publications or promotional materials, in any medium now known or developed in the future without any restrictions. If you object to ISU using your image or voice or your child’s/children’s image or voice in this manner, please notify the program leader, in writing, upon submission of this Agreement.

MEDICAL EMERGENCY PARENTAL PERMISSION
I understand that my child must be healthy and reasonably fit in order to safely participate in this program’s activities. My child or I will inform the program leader(s) of any medication, ailment, condition, or injury that may affect his/her ability to participate safely. If an injury or other medical condition occurs during the program we will take reasonable steps to notify the emergency contacts listed. I hereby give permission to the program representative to provide routine first aid and seek emergency treatment including X-rays or routine tests. I agree to the release of any record necessary for treatment, referral, billing or insurance purposes. I understand that I am financially responsible for payment to the attending physicians or health care unit. In the event of an emergency where the Emergency Contact listed above cannot be reached, I give permission to the physician/hospital selected to secure and administer treatment for my child, including hospitalization.

ASSUMPTION OF RISK AND RELEASE OF LIABILITY
I give permission for my child to participate in the Iowa State Dance Team Prep Clinic at Iowa State University. I understand that program activities may involve certain risks of physical activity and possible injury and that Iowa State University and ISU Athletics will provide each participant with reasonable care, but that ISU cannot guarantee that my child will remain free of injury. I nonetheless wish to have my child participate in the program activities and ASSUME the RISK of participating. I agree to RELEASE from LIABILITY, INDEMNIFY and HOLD HARMLESS Iowa State University; State of Iowa; Board of Regents - State of Iowa; and their officers, employees and agents (hereinafter the RELEASEES) from any and all claim and/or cause of action arising out of and related to any injury, loss, penalties, damage, settlement, costs or other expenses or liabilities that occur as a result of my child’s participation in this program. This Assumption of Risk, however, is not intended to release the above-mentioned RELEASEES from liability arising out of their negligence. I hereby further agree that this Release and Waiver of Liability shall be construed in accordance with the laws of the State of Iowa.

I am over 18 years of age, or the legal parent or guardian for the above participant. I have read and understand all of the conditions set forth above, agree to those conditions, and do so voluntarily. You must agree to the Participation Agreement and Waiver.

Your Price: $60.00