Summer 2008 Registration Form

Parent Name:_____________________________________________

 Address:_________________________________________________

 Town:________________________ ST:__________ Zip:__________

 Home Ph_________________________________________________

 Cell Ph:__________________________________________________

 Email:___________________________________________________

 Student Name:____________________________ DOB:___________

 Student Name:____________________________ DOB:___________

 Class/Day/Time:___________________________________________

 Class/Day/Time:___________________________________________                   

 Class/Day/Time:___________________________________________

 Class/Day/Time:___________________________________________

              *Note: Full tuition is due at time of 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.

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.

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