HSSD WAIVER- REG FORM

Dancer's FULL Name*
Parent/ Guardian FULL Name*
Parent/ Guardian Email*
example@example.com
Parent/ Guardian Cell Phone*
Hm. Phone
Mailing address*
(123 Street Name, City, State, Zip Code)
Student's Date of Birth (MM/DD/YYYY)*
CURRENT AGE*
Please Specify Location of Choice- STONE OAK or BOERNE*
I/We realize the possible risk of injury in all classes offered at Heather Stolle's School of Dance. Therefore, I am releasing and waiving Heather Stolle's School of Dance, the owner, staff and instructors from any liabilities, claims, expenses that may arise from participation in any classes offered.
Dancer's FULL NAME*
Parent/ Guardian Signature*

Clear
Date*

MonthDayYear
Date
What type of class is your dancer interested in?
Should be Empty: