SLATER’S DANCE STUDI0
5809 Deale-Churchton Road,  Deale, MD   20751
410-867-0500,  www.slatersdancestudio.com
STUDENT’S NAME:
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ADDRESS:
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TELEPHONE:				CELL: 			WORK:
EMAIL:
PARENT OR GUARDIAN:
Medical Information:  Allergies, restriction, Special learning needs
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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.
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