Monday, May 20, 2013

Bring A Friend To Dance - Guest Registration Form


2012 - 2013 GUEST REGISTRATION FORM

PERSONAL INFORMATION
Student (guest)Name_________________________________________________________________________________

Student Date of Birth: ____/_____/______

Parent/Guardian Ph. Contact # ______________________ other # __________________ other #___________________

Share your email here to be added to our MAILING LIST….
Parent’s Email address_______________________________________________________


Special Needs/Allergies:______________________________________________________________________________

Participation Waiver ~
I hereby certify that my child is in normal health and capable of participating safely in Creative Movement Center’s programs. I assume all risks and hazards incidental to the conduct of the program and hereby release CMC or its instructor from any and all claims for damages and injuries which may be sustained while participating in any and all activities connected with CMC.
Parent/Guardian Signature_____________________________________________ Date_________________


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