SLATER’S DANCE STUDI0
5809 Deale-Churchton Road,  Deale, MD   20751
410-353-7512,  www.slatersdancestudio.com
STUDENT’S NAME:_______________________________
AGE:					BIRTHDATE:
ADDRESS:
CITY& STATE:
TELEPHONE:				CELL: 			WORK:
EMAIL:
PARENT OR GUARDIAN:
Medical Information:  Allergies, restriction, Special learning needs
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CLASS				Day, Time				Hours
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RELEASE FORM: I_____________________release Slater’s Dance Studio and its’s teachers from any liability, claims, judgements or demands arising as a result of any course of instruction or supervision at SLATER’S DANCE STUDIO or any shows away from studio.  Slater’s is following CDC COVID recommendations temp checks, maintaining 6foot space, and sanitizing all frequent touch points. I have filled out the wellness sheet. 
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