Saint John the Baptist Greek Orthodox Church, Anaheim, Dance Registration

HOUSEHOLD INFORMATION

Family Last Name:
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Mother’s First Name:
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Mother's Last name:
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Mother’s Cell Phone:
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Mother’s Email:
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Father’s First Name:
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Father's Last name:
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Father’s Cell Phone:
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Father’s Email:
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Home Phone Number:
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Home Address:
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City
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Zipcode
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Emergency Contact Person:
First Name
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Emergency Contact Person:
Last Name
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Emergency Contact Person’s Phone Number:
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Emergency Contact Person’s Relationship
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For Parents

Please mark the committee(s) you are interested to volunteer in support the Saint John the Baptist Greek Orthodox Church, Anaheim Dance Ministry:
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Do you have any special talents you would like to offer the dance ministry program?
i.e. sewing, knitting, prop making, etc.
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Any suggestions or comments you would like to offer?
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St. John the Baptist Greek Orthodox Church, Anaheim

Dance Ministry Participation Form
2021-2022 Ecclesiastical Year
Dancer's Full Name
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Date of Birth
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Grade in Fall 2021
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Medical Concerns
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Medical Notes
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Regular Medications
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Home Address
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City
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Zip Code
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Home Phone
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Mothers Phone Number
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Mothers Email
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Fathers Phone Number
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Fathers Email
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Emergency Contact
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Emergency Contacts Relationship
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Emergency Contacts Phone Number
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Parents, by signing this form, you are stating that:

  1. You are a parent or legal guardian of the youth, under 18 years of age, whose information is herein provided, and that you are legally authorized to act on behalf of said youth;
  2. You grant your child permission to participate in the dance program.

Parent Signature (If dancer is a Minor) or Adult Dancer Signature:

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Relationship to Dancer
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St. John the Baptist Greek Orthodox Church, Anaheim

Dance Ministry Photographic Release
2021-2022 Ecclesiastical Year
Dancer's Full Name
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Date of Birth
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Home Address
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City
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Zip Code
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PHOTOGRAPHIC RELEASE:
I/We permit Saint John the Baptist Greek Orthodox Church Greek Dance Ministry to use and publish photographs and/or video of me/my children for the purpose of presenting cultural activities to the community and to promote its Greek Dance Programs. I/We also give permission to release such photographs and video to the news and media in support of the educational and cultural programs.
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Relationship to Dancer
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Dancer's Full Name
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Date of Birth
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Home Address
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City
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Zip Code
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AUTHORIZATION FOR CONSENT FOR MEDICAL TREATMENT FOR A MINOR
I/We the undersigned dancer(s)/parent(s)/legal guardian(s) of the registered dancer(s), a minor, do hereby authorize St John the Baptist Greek Orthodox Church Greek Dance Board, Directors, Board, Parent Representative(s) or Parents of the group acting in the capacity or activity supervisor/vehicle driver for the undersigned to consent to any X-Ray examination, anesthetic, medical or surgical diagnosis or treatment under the General or special supervision of any physician and surgeon licensed under the provisions of the Medical Practice Act. It is understood that this authorization is given in advance of any specific diagnosis, treatment or hospital care being required but is given to provide authority and power on the part of my/our aforesaid agent(s) to give specific consent to any and all diagnosis or treatment or hospital care which the aforementioned physician in the exercise of his best judgment may deem advisable.

Signature of Authorized Parent/Guardian Note:


No treatment will be authorized by the representative of St. John the Baptist Greek Orthodox Church until every reasonable effort has been made to contact the parent or guardian.
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Relationship to Dancer
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Dancer's Full Name
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Date of Birth
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Home Address
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City
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Zip Code
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WAIVER OF LIABILITY (PLEASE READ BEFORE SIGNING)
This agreement waives and releases St. John the Baptist Greek Dance Ministry from all liability relating to injuries that may occur during practices, performances and traveling, on and off site. By signing this agreement, I/We agree to hold St. John the Baptist Greek Dance Ministry and its affiliates entirely free from any liability, including financial responsibility for injuries incurred, regardless of whether injuries are caused by negligence. I/We hereby give consent to have my child participate in St. John Greek Dance Ministry and agree to hold harmless St. John Greek Dance, the church, employees, directors, board, and volunteers from any and all liability, claims, demands, for injury that may be sustained by me, my child, or any property belonging to my child or me. I/We also acknowledge the risks involved in Greek dance. These include but are not limited to personal injury and property damage. I/We swear that I am participating voluntarily, and that all risks have been made clear to me. Additionally, I/We do not have any conditions that will increase my likelihood of experiencing injuries while engaging in this activity. By signing below I/We forfeit all right to bring a suit against St. John the Baptist Greek Dance Ministry, the church, its Board, Directors and affiliates for any reason. In return, I/ We will receive participation in all Greek Dance Ministry activities. I/We will also make every effort to obey safety precautions as listed in writing and as explained to me verbally. I/We will ask for clarification when needed. I, fully understand and agree to the above terms.
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Relationship to Dancer
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DANCER'S INFO

First name:
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Last name:
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Cell Phone:
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Email address:
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Date of Birth:
You Must Select The Year First, Then Month Then Day
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Age at FDF:
0.00
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if({dancer_age_at_fdf}<2):

Are you sure the Date of Birth is Correct? Select the Year First, then Month and Date.

endif;
Dance Group:
  • - select a option -
  • Unknown
  • Avra
  • Nea Zoe
  • Nea Elpida
  • Thiasos
  • Enotita
  • Dynami
- select a option -
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Grade in 2021-2022 School Year:
  • - select a option -
  • PK
  • K
  • 1st Grade
  • 2nd Grade
  • 3rd Grade
  • 4th Grade
  • 5th Grade
  • 6th Grade
  • 7th Grade
  • 8th Grade
  • 9th Grade
  • 10th Grade
  • 11th Grade
  • 12th Grade
  • College/Young Adult
- select a option -
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Would the dancer be interested in participating in a Choral Competition Group?
  • - select a option -
  • Yes
  • No
  • Maybe
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Does your dancer have any medical issues/allergies?
  • - select a option -
  • Yes
  • No
- select a option -
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If yes, please briefly explain:
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Please list any regular medications and directions dance director should know of:
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Insurance Carrier:
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Policy Number:
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Primary Doctor’s Name:
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Doctor’s Phone Number:
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To Register Additional Dancers Please click the Green + Sign

I would like to give a gift above & beyond my tuition to help support the Saint John the Baptist Greek Orthodox Church – Anaheim Dance Ministry and/or earmark this donation to financially assist another dancer in need.
  • - select a option -
  • 0
  • 25.00
  • 50.00
  • 100.00
- select a option -
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Amount Due Including Registration and Tuition:

1St Dancer$0.00
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Additional Dancer's$0.00
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Donation$0.00
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Total Due:$0.00
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Number of Additional Dancer's0
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PHOTOGRAPHIC RELEASE
I/We permit Saint John the Baptist Greek Orthodox Church Greek Dance Ministry to use and publish photographs and/or video of me/my children for the purpose of presenting cultural activities to the community and to promote its Greek Dance Programs. I/We also give permission to release such photographs and video to the news and media in support of the educational and cultural programs.
Field is required!
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As the parent(s)/legal guardian(s) of the above listed dancer(s), I/we understand and agree to the following:


Tuition is for the 2021-2022 Ecclesiastical Year and is a Non-Refundable Fee and applicable to all groups representing Saint John the Baptist Greek Orthodox Church in Anaheim, and is as follows:
  • $375 for the first dancer,
  • $335 for each subsequent dancer of the same immediate family,
  • plus a $100 costume rental fee, *you may be subject to an additional costume rental fee is the dancers groups requires additional costume use which will be collected at a later designated time.
  • plus a $25 Dance Preview Fee per dancer for the Ecclesiastical Year.
  • Please Note: A Security Deposit will be required at time of costume distribution which will be returned upon collection of costume at the end of the season as long as costume is in proper and acceptable condition as defined in your costume contract. In the event of loss or damage, the parents and/or dancer will be held responsible for the replacement value of the costume which will be determined by the Greek Dance Board. *Applicable to Non-FDF Participants: Those who participate in the Saint John the Baptist Greek Dance Ministry but do not attend FDF may be eligible for a costume fee refund as determined by the Greek Dance Board.

REGISTRATION ENDS 9/30.


If tuition is not fully paid by this date then the dancer may not continue to participate in the program.
  • I will be required to pay tuition between 9/1/21 – 10/31/21.
  • As of November 1st, any delinquency in tuition payments may cause the student to discontinue participation from the program until tuition is resolved. Any delinquent payments past November 30th will be considered delinquent and therefore the dancer will no longer be able to participate in the program for the remainder of the year; all paid registration and fees associated with the program will be forfeited.
  • Please notify the parish priest and/or Dance Board President if you are interested in applying for financial aid.

Code of Conduct:


I/We a Saint John the Baptist Greek Orthodox Church Dancer, Parent/Legal Guardian of a minor dancer, acknowledge and agree to abide by the Code of Conduct issued by Saint John the Baptist Greek Orthodox Church Dance Ministry Board and further agree to accept the consequences for any action that violates the rules of conduct as outlined below:
  • Dancer/Family, Must be a parishioner in good standing in a parish of the Greek Orthodox Archdiocese of America and participate in the liturgical life of the church regularly.
  • All dancers must attend church school with regularity and maintain a 50% attendance rate inorder to be considered eligible to attend and perform at FDF. Clergy will evaluate and approve all FDF participant rosters that represent Saint John the Baptist Greek Orthodox Church.
  • All final performance decisions are at the discretion of the Director and Dance Board. Failure to comply with any and all Director’s performance decisions will be subject to immediate disruption of the dancer’s participation in the program. Such instances include but are not limited to dance participation and/or placement in the dance routine, wearing unapproved costumes/accessories, parental undue influence and/or communication to director or program.
  • Dancer/Family acknowledges and agrees to follow all Rules and Regulations, Code of Conduct and Dress Code as set forth by the Metropolis of San Francisco and Folk Dance & Choral Festival Board of Trustees. For detailed information please visit the FDF website at www.yourfdf.org and read the applicable Director’s Manual.
  • Dancer/Family acknowledges that if the said dancer/family is found in violation of any of the FDF Rules and Regulations, Code of Conduct and/or Dress Code, and results in team probation, disqualification and possible eviction from any of the contracted facilities/venues for the Greek Orthodox Folk Dance & Choral Festival. Probation Participants who break the Code of Conduct, whether dancer, singer, parent, chaperone or nonparticipant spectator, will have their entire group or groups from their parish immediately put on probation. Depending on the severity of the infraction the individual participant(s) involved and/or the entire group risks the possibility of exclusion from receiving any awards. Groups placed on probation will remain on probation for the remainder of the weekend as well as through the duration of the following year’s FDF. Any additional rule infractions while on probation will result in disqualification. If a first time offense by a team is disputed, a committee comprised of three members of the FDF Board of Trustees will review the circumstances arising from the rule infraction and subject to further review and consequences as deemed appropriate by the Saint John the Baptist Greek Orthodox Parish Priest and Greek Dance Ministry Board.

Dress Code Guideline:

  • Each participant should use good judgment to determine what is appropriate dress for a church sponsored and/or related events. Clothing choices should be modest – not overly revealing or potentially scandalous in any way. Please respect yourself and others by dressing in an appropriate manner. Dancers should learn to make choices regarding clothing and appearance that attract attention to one’s personal countenance rather that one’s physical attractiveness.

Social Media Guidelines:

  • Be a responsible Digital Citizen by using the internet and social media in a responsible and ethical way. Dancer choices in exercising Digital Citizenship should arise from character qualities of the heart and reflect a Christian Spirit.

Dancers understand that participating in Saint John the Baptist Dance Ministry program is a privilege. If the dancer or parent(s) cannot abide by the requirements under the parish Code of Conduct, the dancer may be asked to leave practice and the violation will be formally addressed. Repeat violations of the parish Code of Conduct may result in additional consequences, up to dismissal and will immediately discontinue participation in the dance program. If the dancer is removed from the program, registration tuition and fees associated with the dance program will be forfeited upon such separation.

Parents, by signing this form, you are stating that:

  1. You are a parent or legal guardian of the youth, under 18 years of age, whose information is herein provided, and that you are legally authorized to act on behalf of said youth;
  2. You grant your child permission to participate in the dance program.

Emergency Authorization:


I/We the undersigned dancer(s)/parent(s)/legal guardian(s) of the registered dancer(s), do hereby authorize the dance directors, parent representative(s) or parents of the group acting in the capacity or activity of supervisor/vehicle driver, as agents for the undersigned to consent to medical, surgical, or dental examination, treatment, etc. in case of emergency. I/We hereby authorize treatment and/or care of the registered dancer(s) at any hospital. If there is an emergency and I/We cannot be reached, please contact the emergency contact person stated above who is hereby authorized to act on the dancer’s behalf. By signing your name below, you are giving Legal Authorization for emergency care acknowledgement of disclaimer.

AUTHORIZATION FOR CONSENT FOR MEDICAL TREATMENT FOR A MINOR:


I/We the undersigned dancer(s)/parent(s)/legal guardian(s) of the registered dancer(s), a minor, do hereby authorize St John the Baptist Greek Orthodox Church Greek Dance Board, Directors, Board, Parent Representative(s) or Parents of the group acting in the capacity or activity supervisor/vehicle driver for the undersigned to consent to any X-Ray examination, anesthetic, medical or surgical diagnosis or treatment under the General or special supervision of any physician and surgeon licensed under the provisions of the Medical Practice Act. It is understood that this authorization is given in advance of any specific diagnosis, treatment or hospital care being required but is given to provide authority and power on the part of my/our aforesaid agent(s) to give specific consent to any and all diagnosis or treatment or hospital care which the aforementioned physician in the exercise of his best judgment may deem advisable.

Signature of Authorized Parent/Guardian Note:


No treatment will be authorized by the representative of St. John the Baptist Greek Orthodox Church until every reasonable effort has been made to contact the parent or guardian.

WAIVER OF LIABILITY (PLEASE READ BEFORE SIGNING):


This agreement waives and releases St. John the Baptist Greek Dance Ministry from all liability relating to injuries that may occur during practices, performances and traveling, on and off site. By signing this agreement, I/We agree to hold St. John the Baptist Greek Dance Ministry and its affiliates entirely free from any liability, including financial responsibility for injuries incurred, regardless of whether injuries are caused by negligence. I/We hereby give consent to have my child participate in St. John Greek Dance Ministry and agree to hold harmless St. John Greek Dance, the church, employees, directors, board, and volunteers from any and all liability, claims, demands, for injury that may be sustained by me, my child, or any property belonging to my child or me. I/We also acknowledge the risks involved in Greek dance. These include but are not limited to personal injury and property damage. I/We swear that I am participating voluntarily, and that all risks have been made clear to me. Additionally, I/We do not have any conditions that will increase my likelihood of experiencing injuries while engaging in this activity. By signing below I/We forfeit all right to bring a suit against St. John the Baptist Greek Dance Ministry, the church, its Board, Directors and affiliates for any reason. In return, I/ We will receive participation in all Greek Dance Ministry activities. I/We will also make every effort to obey safety precautions as listed in writing and as explained to me verbally. I/We will ask for clarification when needed. I, fully understand and agree to the above terms.
Enter Your Name Here
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  • Relationship to the Dancer
  • Mother
  • Father
  • Self
  • Other
Relationship to the Dancer
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Relationship to Dancer
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Select a date
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