https://d1y502jg6fpugt.cloudfront.net/37070/archive/files/9dd8b2129819fb0d2448699da99c6c61.pdf?Expires=1777507200&Signature=Jm9AaP7BpYtPS3%7E1f2Hxyx-XU-%7Emh9plQh-wJHWfsFB84CfMjY17LNtRBfAbb29Co1DElfzVnQ-CPi8Uiv0yeTA6I9JUjVU76VRAzKQFK2ryvFC6EFsglOQ95QBikTC%7Ekni7ZwR1XW2hZClWI6bvut40uJXzee3gkg780Elm2ztaR5NTyYTHUMnOPDkU69J7ZOFnPLPIZQxZvClu2A%7EjbgWUvjQt6O82vmX70rbvghbGhOCYSZc1%7EFC1U7xTvqv-dTxR7OMxlSRtpdsLKmQiFC6MJFDWsAB3o6hOhCUUhhWErSKM6sovH%7Ehkmraq3b%7E1XHYAuYKPqpDZkHloNsXMdg__&Key-Pair-Id=K6UGZS9ZTDSZM 28f5c2bb6a1c944c236db449a64b6773 PDF Text Text .' 0 ~fjif fmft~f Att5kor Datte~ Tro"'p~. lttc. ID#_ __ For Staff Use Onl . ~I _______P_e_r_m_i_s_si_o_n_S_li~p_f_o_r_A_d_u_l_t_M_e_m_b_e_r_s_ _ _ _ _ _ ___. The . Angkor Dance Troupe is a non-profit organization dedicated to t~e preservation and promotion of Cambodian culture and positive recreational and educational opportunities for youth . Membership is open to anyone willing to make a commitment to Cambodian dance. The Angkor Dance Troupe does not discriminate on the basis of gender, age, religion, ethnicity, sexual orientation, or disability. Information about you (the dancer) - please print: Today's Date: _ _ _ __ Name: Street Address & Apartment or Unit # Telephone. # _ _ _ _ _ _ _ _ _ _ _ __ City State Zip Code Date of Birth: _ _ _ _ _ _ __ Pager/Cell Phone: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Gender: M F • I understand I will be participating in dance rehearsals at the Mogan Cultural Center, 40 French Street, Lowell and in public performances and group outings at various locations throughout the region. • I give permission to be photographed and/or videotaped by staff, volunteers, visitors, audience members, professional photographers, and/or the news media for the purposes of documenting or promoting the Angkor Dance Troupe. • I give permission for staff members to use their best judgment in the event that medical treatment is required in an emergency. • I agree to hold Angkor Dance Troupe staff and volunteers free from liability for any damages. Please Sign: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Emergency c o n t a c t : - - - - - - - - - - - - Phone: ~---'------Does you have any medical conditions or other issues we should know about.? (please explain): _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Health Insurance Company & Policy# _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Insurance Card Holder's N a m e : - - - - - - - - - - - - - - - - - - - (If your are not insured, please write "UNINSURED ." This does not exclude you from participating in the program .) P.O. Box 1553 •Lowell, MA 01853 • (978) 441-9277 •FAX: (978) 275-1824 �tff t$~tt1~t~~ 0 Att5ltor Dattce Tro~pe, lttc. This f9rm should be filled oyt by the head of the household .. The following information is being collected from all members of the Angkor Dance Troupe to help us obtain a grant from the City of Lowell. The information will be kept completely confidential (private). CHILD NAME(s): 1. How many people live in ygur household? Include everyone that you share living space and expenses with, including people who are not related to you . Enter the total number of people here: ------ D Yes 0 2·. Is the head of the household a female? 3. Is there anyone in your house who has a perm(Jnent disability? If Yes, how many? _ _ _ __ No D Yes D No D 0Yes No 4. Is anyone in your house 60 yesirs old or 9lder? If Yes, how many? 5. How mapy in your househ,dld are: Male (enter #) ____ Female (enter #) _ _ ---- 6. How majny in your household are: Asian (enter #) White (enter #) _ _ I Hispanic (enter #) _ _ African American - - Other:--..ple..,...,as-e. ,. . sp.. . ,.ec1y_ _ __ ..-l 7. Is the chi.Id enrolled in the Troupe a fgster child 'through an agency such as DSS? (If you answered y~s to guesljon #7. stop here. You do not need to fill out the rest of this form. Please return partially completed form to Troupe.) 8. Circle the amount below that is closest to the total amount of money that everyone in your household receives each month: Amount circled should be monthly income of all household members combioeg. (If yo1;ir total income falls between two numbers, please circle the larger of the two numbers .) $1,229 $2,317 $3,500 $5,425 $1,404 $2,342 $3,625 $5,775 $1, 579 $2,633 . $3, 863 $1, 754 $2, 925 $3,938 $1,896 $3,063 $4,375 $2,038 $3, 158 $4, 725 $2, 175 $3,392 $5,075 - '· I certify that the above information is true and correct to the best of my knowledge . Parent/Guardian : Date: (?~eas'( ---~-- sl-511 .) �October 2002 Angkor Dance Troupe Policies and Procedures To: All dancers and staff Fm: Tim Thou, Phousita Huy, and Ruth Page Re: Contract concerning appropriate behavior during troupe rehearsals and other operations Dt: October l , 2002 These rules have.. been developed for your safety and to ensure that we use our facility properly and respectfully. All dancers and staff must sign and Feturn this contract. ~ STAIRWELL - At no time, should any dancers lean over the stairway railing on the second or third floor stairwell.This is a very important safety rule. If you are seen hanging over the railing, you will be issued a verbal warning, and a written record will be made in the office. Repeat offenders will be suspended from the program. )> STRANGERS - If you see someone walking through the halls or rehearsal rooms that you do not recognize as a member or family member of a troupe dancer, notify an adult staff person at once. Adult staff will inquire about the nature of the visit, and if appropriate, have the guest sign in and receive a guest pass. )> FIRE ALARMS - If a fire alarm goes off, immediately leave the rehearsal rooms and make your way down the stairs. Use the buddy system - leave the building with at least one other person from the .troupe. Members will gather in front of the building until we are told it is safe to return. If the front of the building is also being evacuated, move over to Boarding House Park next to the building. Stay together as a group. DO NOT ASSUME IT IS A FALSE ALARM unless an .QQ.\.!11 staff member tells you so (Adult staff include Mehmed Ali who works in the office in the lobby and/or anyone in a Lowell National Park uniform.) Building Poff cf es )> FIRE/ELEVATOR ALARMS - Do not tamper with fire or elevator alarms unless there is an emergency. It is illegal to pull a fire alarm as a prank. > COMMON AREA POLICY - Please be quiet and respectful when using the "common areas" of the building. These include the lobby, elevator, and stairways. Absolutely no yelling over the railings to someone upstairs or downstairs. No wrestling, pushing or otherwise rowdy behavior. There are offices and a museum exhibit on the first and second floor. We must not disturb our fellow tenants. If you are rehearsing in the third floor lobby, please close the doors to the stairwell. )> CLIMATE CONTROL-.Thermostats should be set at 70 degrees at all times. Do not tamper with thermostats. Please report any concerns about excessive heat or air conditioning to an · adult staff member right away. Rehearsal Policies ' '· )> DRESS CODE-All dancers must adhere to our rehearsal dress code: K'ben and An Noy for girls and sweats for boys. No jeans are permitted. )> RESPECT - Be respectful at all times of master teachers and assistant instructors. )> LANGUAGE- No profanity (swearing) is aliowed. No te.osing, arguing, or otherwise "hurtful" language. Please treat your fellow dancers as you wish to be treated. )> DISCRIMINATION- No one will be discriminated against or in any way harassed on the basis of race, sex, age, or disability. Report violations at once to an adult staff member. We have a ZERO toierance policy concerning discrimination. )> NO CELL PHONES- No cell phones are allowed in rehearsal rooms . You must turn off your cell phone during rehearsal. · )> OTHER- You must inform your instructor if you nee· to leave a rehearsal room during d · rehearsal. Please minimize your "comings and goings." It is disruptive to our rehearsals if dancers.are constantly leaving and re-entering. )> �October 2002 ID Cards (Beginning November 2002) };> All members and staff will be issued laminated photo ID cards with a breakaway cord/lanyard to wear around their necks. , };> Once you are issued an ID card, you must wear it at all times while at the troupe's headquarters at the Mogan Center and at performances - except when you are actually rehearsing or performing. Hooks will be installed in all of the rehearsal rooms so that you can remove your ID card while rehearsing, but you must wear your'card whenever you leave a rehearsal room and use the halls. };> It is your responsibili.ty to bring your ID card to every rehearsal. For your convenience, we will install a rack at the Mogan Center where you can leave your card between rehearsals . Anyone losing a card will be charged $4.00 for a replacement. Guest Polley (Beginning October 2002) };> If current members have friends who may be interested in joining the troupe, members are welcome to bring a friend to a rehearsal as a guest ONE TIME ONLY. If the guest wishes to return, he or she must enroll. };> All guests must report to the office where they will sign in and be issued a guest pass. If you bring a guest, it is YOUR responsibility to escort your friend to the office to sign them in. If no staff is present in the office, please bring your guest to Ms. Phousita or one of the Assistant Instructors. };> If you bring a guest, you are responsible for supervising him/her and making sure he/she complies with all Angkor Dance Troupe policies regarding safety and proper use of our facility. };> If you see someone in the hall or third floor rooms who does not have a guest pass or member ID card, please inform a staff member or assistant instructor who will approach the guest and ask if they have signed in. Media Polley )> If a newspaper photographer takes a photo that includes you during a performance or rehearsal and asks for your name for the photo caption, you must also say that you are a performerwith the Angkor Dance Troupe. Contract between member and the Angkor Dance Troupe: I have read these policies carefully and agree to abide by them. ID# Signature:_-'-:-:--~--::-:----:----------------­ Member Signature Date � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Angkor Dance Troupe, Inc. Collection, 1991-2017 Creator An entity primarily responsible for making the resource Angkor Dance Troupe, Inc. Source A related resource from which the described resource is derived Angkor Dance Troupe, Inc. Collection, 1991-2017. UML 5. Center for Lowell History, University of Massachusetts Lowell, Lowell, MA. Description An account of the resource Angkor Dance Troupe, Inc. is a 501(c)3 nonprofit is dedicated to preserving the traditions of Cambodian performing arts while providing a positive social and educational environment for their young members. The collection includes financial records, board of directors records, correspondence, program files, and photographs. <br /><br />View the collection finding aid for more information, <a href="https://libguides.uml.edu/uml5">https://libguides.uml.edu/uml5</a>.<br /><br />Part of the collection is accessible on this site. <br /><br />-------------------- <br />SEADA would like to thank the following individuals for their work in making this collection available online: Monita Chea, Soumeng Chea, Julia Huynh, and Vivien Zhuo. <br /><br />SEADA would like to thank the following individuals for their help with describing photographs, dating items, and identifying individuals featured in photographs and other materials: Linda Chan Flynn, Emaly Horn, Khakhada Horn, Channa Sath, and Tim Thou. Relation A related resource The collection finding aid, <a href="https://libguides.uml.edu/uml5" target="_blank" rel="noreferrer noopener">https://libguides.uml.edu/uml5</a>. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Angkor Dance Troupe permission slip for adult members, 2002 Subject The topic of the resource Community organization Dance--Cambodia Lowell (Mass.) Nonprofit organizations Description An account of the resource Angkor Dance Troupe permission slip for adult members. Includes information on public performances and group outings, permission on being photographed and videotaped, permission for medical emergencies, and the organization's list of policies and procedures. Source A related resource from which the described resource is derived Angkor Dance Troupe, Inc. Collection Publisher An entity responsible for making the resource available Angkor Dance Troupe, Inc. Date A point or period of time associated with an event in the lifecycle of the resource 2002 Rights Information about rights held in and over the resource UMass Lowell Library makes this material available for private, educational, and research use. It is the responsibility of the user to secure any needed permissions from rightsholders, for uses such as commercial reproductions of copyrighted works. Contact host institution for more information. Format The file format, physical medium, or dimensions of the resource 4 p.; 28 x 21.5 Language A language of the resource English Type The nature or genre of the resource text Identifier An unambiguous reference to the resource within a given context uml5_b10_f12_i002 Coverage The spatial or temporal topic of the resource, the spatial applicability of the resource, or the jurisdiction under which the resource is relevant Lowell, Massachusetts 2000-2009 Cambodians Documents