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Summer 2012 Workshop Application

Housing and Work-Study application forms will be sent to you after your workshop registration is received. Remember to check off your interest in applying for housing and work-study on the Summer 2011 Workshop Application form.

PERSONAL AND CONTACT INFORMATION:

* indicates a required field

First Name: *  
Last Name: *  
Date of Birth: *  
Address: *  
City: *  
State: *  
Zip: *  
Email: *  
Phone (day): *  
Phone (evening):  
Emergency Contact Name: *  
Emergency Contact Phone: *  
Emergency Contact Email: *  



CLASS OPTIONS:

BODYWORK, 2:15-3:45PM – please rank classes in order of preference, #1 being your first choice, #2 your second choice

BALLET: *  
SOMATICS: *  


AFTERNOON ELECTIVES, 4-5:45PM – please rank ALL classes in order of preference, #1 being your first choice, #5 being your last choice.

Choreographic Devices: *  
Repertory I: Large Work: *  
Repertory II: Exploring Excerpts: *  
Principles of Performance: *  
New Work: *  


HOUSING AND WORK STUDY:

I am interested in applying for on-campus housing. Check this box if you wish to receive housing information and application forms when they are available.

I am interested in applying for work-study. Check this box if you wish to receive a work-study application form.

I am interested in part-time study. If you check this box, you will not be registered in the full workshop, but will be placed on a waiting list, until all other registration has been completed, at which point, space permitting, we may accept a small number of part-time participants.

REGISTRATION CONTRACT, PHOTO RELEASE & LIABILITY WAIVER:

  1. By registering for the Summer Workshop, I hereby pledge that I am available for the duration of the workshop, and plan to attend the full workshop with no absences, except in cases of unforeseen emergency, under which circumstances I will notify the administration of my absence to the best of my ability.
  2.  
  3. I grant to Dova, Inc., its representatives and employees the right to take photographs of me and my property in connection with the above-identified subject. I authorize Dova, Inc., its assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that Dova, Inc. may use such photographs of me with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photograph.
  4. I agree to indemnify and hold harmless Dova, Inc. a.k.a. Doug Varone and Dancers, and any of its faculty or staff members, and Purchase College and any of its faculty or staff members, and the People of the State of New York from any and all claims, suits, actions, damages and costs of every nature and description arising out of or relating to the use of the Purchase College facilities, including but not limited to appurtenances, surrounding grounds, campus residences, campus gym and other campus facilities, transportation in any vehicles operated by Dova, Inc., its staff, volunteers, or interns, and for any injuries sustained, accidents incurred or illnesses contracted by me while a participant of the Doug Varone and Dancers Summer 2012 Workshop scheduled to take place between June 3 and 23, 2012. I further agree that I will not hold Dova, Inc. or Purchase College responsible for the loss or damage of personal property while in attendance. I agree not to hold Dova, Inc. liable for damages of any kind in the event Purchase College revokes, prior to June 3, 2012, its permit for Dova, Inc. to conduct the workshop. I understand that refund requests will only be considered with written notice of cancellation. Full tuition refunds granted with notice given by May 7, 2012; 50% tuition refunds granted with notice given between May 8 and 25, 2012; requests made after May 25 will be reviewed on a case-by-case basis. Teachers, classes and schedule are subject to change.

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