Ironwood Dance Company

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

Phone 906-932-1661 E-mail: Margaret@ironwooddance.com