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Little DancersBallet Classes
For more information, please call Ms. Alida at (301) 208-6798 or
email at [email protected].
Check out our website at www.littledancersballet.com
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CHILD 'S NAME: AGE: DOB:
PARENT 'S NAME:
EMAIL :
HOME PHONE: WORK/CELL:
L ITTLE DANCER 'S HAS MY PERMISSION TO PHOTOGRAPH
MY CHILD DURING CLASS: YES NO WAIVER: L ITTLE DANCERS ASSUME NO L IABIL ITY FOR INJURIES OR DAMAGES ARIS ING FROM THE RESULTS OF PARTICIPATION. DUE TO
STRENUOUS NATURE OF SOME ACTIVIT IES , THE PARTICIPANT IS URGED TO CONSULT PHYSICIAN CONCERNING F ITNESS TO
PARTICIPATE. I HEREBY APPROVE OF MY CHILD 'S PARTICIPATION IN THE BALLET CLASSES AND CONSENT TO EMERGENCY TREATMENT
FOR MY CHILD ON MY BEHALF. TO THE BEST OF MY KNOWLEDGE THERE ARE NO PHYSICAL OR OTHER CONDIT IONS WHICH WILL
INTERFERE WITH MY CHILD 'S PARTICIPATION. ANSWERING YES ABOVE TO HAVING MY CHILD PHOTOGRAPHED/VIDEO, I HEREBY
APPROVE ANY USE OF THE PHOTOGRAPHS TAKEN TO BE USED IN SOCIAL MEDIA, WEBSITE CONTENT OR PROMOTIONAL CONTENT
RELATED ONLY TO L ITTLE DANCERS.
PARENT/GUARDIAN SIGNATURE:
Monthly Payment: $75.00 charged to your school accountAnnual Enrollment Fee: $30.00 (checks payable to Little Dancers)
Dance Attire: Leotard, tights and ballet shoes