2008 Summer Registration

Print this out and mail it to Dancenters 1321 Main Street Reading MA 02167 along with full payment.

Please call the main office at 781*942*3700 to find tuition rates.

Parent Name:__________________________________________________________________

 Address:____________________________Town:_____________________Zip:_____________

 Home Ph____________________Cell Ph:______________________Work Ph:_______________

 Email:________________________________________________________________________

 Emergency Contact:____________________________Ph:_______________________________

 Student Name:____________________________ DOB:___________ Years at Dancenter:_____

 Student Name:____________________________ DOB:___________ Years at Dancenter:_____

 Student Name:____________________________ DOB:___________ Years at Dancenter:_____

 Class/Day/Time:_________________________________________________________________

 Class/Day/Time:_________________________________________________________________

 Class/Day/Time:_________________________________________________________________

          N.R. Princess Camp (June 23-27)

            Stoneham Princess Camp (July 20-25)

            Dance Intensive Intermediate Level

            Dance Intensive Advanced Level

RELEASE FROM LIABILITY: I do hereby release Susan Woods’ Dancenters and anyone employed by Susan Woods’ Dancenters from any liability occurring on or around the studio premises, or at any function held at other locations in connection with dance classes in which the student(s) named above is/are enrolled.

POLICIES AND PROCEUDRES: I have read and agree to all of Susan Woods’ Dancenters policies and procedures and I also give Susan Woods’ Dancenters the right to use photographs of my child in dance class or from recital pictures in the future for advertising or on the website.

__________________________________       __________________

                   (signature)                                          (date)

*Note: Full tuition is due at time of Registration*