Dance Camp Registration Form

Name_____________________ ______________________________ __________
First Last M.I


Address__________________________________ _________
Street apt.#
__________________________________ _________ ____________
City State Zip Code

Phone #_____________________ _____________________ _____________________
Work Home Cell

Email_____________________________ Birthday________ _________ _________
Month Day Year
Camp Name & Dates Registering For_______________________________________________________

How Did You Hear Of Muse for Life?________________________________________________________
______________________________________________________________________________________________
Contract of Permission and Policies:
I _______________________(print parent or guardian name),___________________(relationship) of the student, will allow my child to participate in classes & class activities which occur during Muse for Life's Dance Camp. I will allow my child's photograph to be used in promotional materials. I understand that these classes will require some physical activity by my child and the risks that may be associated with such activity. No refunds are granted for classes not attended by student. No liability is assumed by Muse for Life, any Muse for Life instructors, or staff for any accidents or injuries. The person herein signing this agreement on behalf of said student, assumes full responsibility. I understand that the charge for registration is $50, and that this $50 registration fee is non-refundable under any circumstances. I understand that the camp dates which I have registered for are the only camp dates which Muse for Life is accountable for services during. Finally, I understand that all payments for the camp are due upon arrival on the first day of camp.

Parent or Guardian signature:_________________________________________________ Date:__________________

Home