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Enrollment and Liability Form

Parent or Guardians First Name

Last name

Phone

Emergency Contact Person

Phone - Emergency Contact

Name of School

City and State

#1 Student's First and Last Name

Star Dancers

Creative Kiddos

Date of Birth

#2 Student's First and Last Name

Date of Birth

#3 Student's First and Last Name

Date of Birth

Please look at your flyer or call me directly at (360) 252 - 0888 for Dance Class Fees information. The box below must be completed in order to submit the form and enroll. Thank you!

Dance Class Fee Per Month (located on your flyer)

As the legal parent or guardian, I release and hold harmless Dance Dynamics its owners and instructors from any and all liability, claims and causes arising out of or related to any loss, damage or injury that may be sustained by the participant while in or upon the premises.

To acknowledge this liability waiver please sign below.

Signature