The Born to Move Dance Company presents...
B2M Performing Arts
Camp 2010
ONLY
$86/
week!
Registration
2012 Camp Registration
Campers name:
Birth date: d/m/y
Grade in Sept. 2012.
Address:
City:
Postal Code:
Home Phone:
Parent Cell Phone:
Please list any
allergies and/or
medications that your
child has/requires.
Emergency Contact
Name:
Emergency Contact
Number:
Emergency Contacts
Relationship to
Camper:
The following people
have my permission
to pick up my child
from camp:
If there is a change to the names listed above, I
will provide the change in writing to the Camp
Director.
Family/Parent E-mail:
Please retype the
above e-mail:
Please check the weeks below, to which you wish to
register your camper.
Don't forget to
pay safely and
securely online
through Paypal
to secure your
child's space.
Registrations
received without
payment WILL
NOT be
accepted, and
will not
guarantee your
child's spot for
that week.
July 16 - 20, 2012.
July 30 - August 3, 2012.
By clicking the submit button you are agreeing to the terms
and conditions listed below.
ELEMENTS OF RISK

The Born to Move Dance Company Performing Arts Camp program, being offered,
involves certain elements of risk.  Accidents may occur while participating in this activity.  
These accidents may cause injury. A few examples of the type of injuries which one is at
risk of having occur while participating in this activity are:
Activity related (e.g., minor cuts and abrasions, sprains and strains, dislocations and
fractures, to more serious injuries affecting the body. Some head, neck, or back injuries
could lead to paralysis or prove to be life threatening.)

These injuries result from the nature of the activity and can occur without any fault on
either the part of the dancer, or the Born to Move Dance Company, its affiliates, its
employees or agents, or the facility where the activity is taking place.  By choosing to
participate in the activity, you are assuming the risk of an injury occurring.   

Carefully following instructions at all times and being physically fit to participate in the
activity can reduce the chance of an injury/accident occurring.
With the acceptance of this application and the permission given to (child’s name listed
above) to participate in any dance/art activity with the Born to Move Dance Company
(B2M Dance Co.) I hereby release, waive and forever discharge the Born to Move Dance
Company and all of their members against all claims (i.e. Liability, damages, costs etc.),
howsoever caused, arising as a result of or in any way connected with (child’s name)
participation in any dance/art activity. By submitting this registration form, I acknowledge
having read, understood and agreed to the above waiver, release and indemnity. I warrant
that the applicant is physically fit to participate in such activity and acknowledge that I
am aware that there are risks associated with it which I hereby agree to entirely assume as
my own personal responsibility. I understand the physical risks involved in this activity and
I do not hold the Born to Move Dance Company or its affiliates accountable for any
injuries that may occur due to (child name) participation in this event.
Due to our low camp rate, $0 registration
fee and limited spaces available we cannot
issue refunds for any reason.  By clicking
the button above you are agreeing to these
terms.
Every Thursday we will be
having a pizza day! Slices of
cheese and/or pepperoni pizza
is available for advanced
purchase only. Juice boxes of
either apple or orange will also
be offered with your advance
online purchase.  Online orders
must be received no later than
4PM on the Wednesday of that
week.

Click here to order your child's
lunch online today!
PIZZA DAY!
THURSDAY!
IMPORTANT 4 PARENTS

Sign-In -  9:00-9:30AM
Sign-Out - 3:30-4:00PM


FOR EVERY 15 MINUTES A CAMPER
IS PICKED UP LATE A $15 CASH
LATE FEE WILL BE OWED TO THE
COUNSELLOR UPON ARRIVAL.
Camp 2010
B2M Performing Arts
Camp 2012
SESSION DATES
July 16-20, 2012.
July 3 - August 3, 2012.
August 7-10, 2012.
Waiting List Only
Click here to pay safely and
securely online through Paypal
to reserve your spot today!
We are the world.
Movie Makers