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Contact us:
Simply Circus, Inc.
info@simplycircus.com
14 Pierrepont Rd
Newton, MA 02462
617-527-0667

Student File Cover Page

First Name		Last Name		Nickname

Date of Birth		student is	years old as of September 2008

Home Address


Home Phone:		Cell Phone:

Email:

School		Grade

Allergies / Special Needs / Other “Red List” Notes or things that our staff should know the student:





Please list at least two local emergency contacts for this student, including their full name and contact details. For minors, this list also serves as our authorized pick-up list.





Reminders:
	Have you signed the Liability Waiver?
	Have you signed the Photographic Release?
	Have you read and signed the Parent Handbook?
	Have you been Added to the Newsletter email list?

Request for Internet Services
	Email Account	Web space	Databases	Photo website
	Email Newsletter
I want to be a participant in following Simply Circus research studies:
	P.T. Screening	Injury Study	Skill/Grade correlation study

CLASS REGISTRATION

Ground Classes
Contortion - Newton Wednesday evenings, 7:30-9:00pm (Monthly, $150)	Monthly, $150
General Circus Arts (ages 7-11) - Concord Saturdays, 10:30-12:00.	Monthly, $150
General Circus Arts (ages 12-18) - Concord Saturdays, 10:30-12:00.	Monthly, $150
Young Adult General Circus - Concord (for ages 16 – 29) Sundays, 2:00-3:30	Monthly, $150
Rolling Globe, Rolling Barrels and Rolla Bola - Concord Saturdays, 12:30-2:00	Monthly, $150
Juggling Club - Concord Saturdays, 12:30-2:00	Monthly, $100
Intermediate Tumbling - Newton Monday Evenings, 6:30 – 8:00.	Monthly, $150
Power Tumbling - Concord Saturdays, 12:30-2:00	Monthly, $150

Aerial Classes
Beginning Aerials - Concord Sundays, 12:30-2:00	Monthly, $150
Intermediate Aerials - Newton (note: must take at least 2 of the 3) Tuesday Evenings, 6:30pm – 8:00pm.	Monthly, $150
Intermediate Aerials - Concord (note: must take at least 2 of the 3) Saturdays, 2:00-3:30pm	Monthly, $150
Intermediate Aerials - Concord (note: must take at least 2 of the 3) Sundays, 2:00-3:30pm	Monthly, $150
Adult Aerials - Concord Sundays, 10:30-12:00	Monthly, $150
Adult Aerials Practice - Newton Thursday Evenings, 7:30-9:00pm	Monthly, $150

Teacher Training Programs
Teacher Training: General Circus Arts - Concord	Monthly, $150
Teacher Training: Aerial Arts - Concord	Monthly, $150
Teacher Training: General and Aerial Arts	Monthly, $250

Copyright © 2003-08 Simply Circus, Inc.
info@simplycircus.com	14 Pierrepont Rd
617-527-0667	Newton, MA 02462
Send mail to Steven Santos with questions or comments about this web site.
Last modified: November 18, 2008