Student's Name:_______________________________
Parent's
Name:________________________________
Mailing Address:_______________________________
_____________________________Zip_______________
Email Address:_________________________________
Phone Number:________________________________
Grade:________________________________________
Male or Female:________________________________
Photo Permission:Your permission is needed for taking general pictures of your
child danacing (name stated above) for digital, printed, tv or website material. Pictures and video footage are taken of
students only at costume and final dance. No personal information is ever displayed and we prefer to use indirect head shots.
The DVD Memory Package is the main reason for this permission, since it allows students to have professional footage of themselves
dancing for the first time. We thank you very much for your cooperation.
_______________________________________
Parent SignatureClass
I_____________ or Class II__________________
(5/6 grade). . . . . . . (7/8 grade)
MONDAY
- Carlsbad (Women's Club)_________
TUESDAY - San Diego
(Women's Club)_________
WEDNESDAY-Orange, O.C.(Women's Club)_________
THURSDAY - Escondido (Woman's
Club)_________
School Name:__________________________________
CLASS FEE (10 Sessions) $175: _____
PARENT TABLE MANNERS
COURSE $25:_____
TOTAL AMOUNT ENCLOSED: _____________________