Spring Dance and Movement Workshop
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Transcript of Spring Dance and Movement Workshop
Spring Dance and Movement WorkshopMay 21, 2011
Parent Name: _________________________________
Email: ________________________________________
Cell Number: __________________________________
In Case of Emergency: ___________________________
Child #1 Name: ______________________ Grade in Fall 2011: __________________
___Pre-K -3rd Grade Session (10:30 am-12:30 pm) ___4th-8th Grade Session (12:30 pm-2: 30 pm)
Child #2 Name: ______________________ Grade in Fall 2011: __________________
____Pre-K through 3rd Grade Session (10:30 am-12:30 pm) ____4th-8th Grade Session (12:30 pm-2: 30 pm)
Child #3 Name: ______________________ Grade in Fall 2011: __________________
____Pre-K through 3rd Grade Session (10:30 am-12:30 pm) ____4th-8th Grade Session (12:30 pm-2:30 pm)
Cost: $15.00 per child ($10 each for multiple children in a family)
I am authorizing my child’s participation in The Studio’s Spring Workshop. I know of no mental or physical problems, which may affect my child’s ability to safely participate. The staff is authorized to attend to any health problem or injury, which may occur while in the workshop. I understand that my child must have current and active medical insurance before he/she can participate. Neither my child nor I will hold The Studio or it’s staff liable for any injuries or expenses related to injuries while my child is participating in the workshop. I have read and understand the terms described above. I authorize my child to participate in The Studio’s Spring Workshop.
___________________ Parent Signature _________________ Date
Please mail registration to:The Studio
15035 SE 124th AveClackamas, OR 97015
Please make checks payable to:Jessica Elliott