No classes offered at this time!! See the fall schedule.
Register with full tuition paid by__________________________________
Student Name ____________________________________________ Date__________________________
Parent(s) Name _________________________________________________________________________
Address_______________________________________ City/State/Zip ____________________________
Phone No._____________________________________ Work ___________________________________
E-Mail _____________________________________________Cell #______________________________
Amount Due _______________ Method of Payment _______Cash _______Check
I understand that participation in this dance program is voluntary and strenuous, and verify that my child/children are physically fit to participate. I agree that I waive and release IDC, Margaret Grachek, their heirs and their assigns from any and all rights and claims for injuries sustain or illnesses contracted by my child while participating in the Summer Intensive Classes 2009.
Parent(s) or legal guardian signature ________________________________________________________
Please remit registration and fees to Ironwood Dance Company E5053 Slade Rd. Ironwood, Mi 49938