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Creative Dance Centre
1141 Holland Drive #11
Boca Raton, FL. 33487

Tel. (561) 997-2691

Creative Dance Centre
2007 Registration Form

Reserve your space in class for fall classes!!! Classes fill up fast!!!! 1st Child’s Name Age DOB         2-nd Child’s Name Age DOB         Parent/Guardian Home# Cell# Street City Zip Email Address         Previous Training         Class Day Time     Class Day Time     Class Day Time         Total Hours Total Tuition Registration Fee Total Due     Liability and Medical Release Emergency Phone # Name and relation of person at this # Does your child have any medical conditions we should be aware of? Please mark No Yes If yes, please expain         I am fully aware of and understand the risks that any activity, which involves motion, rotation, height and inversion, may cause accidental injury. I hereby waive and release CREATIVE DANCE CENTRE and it’s employees from any and all claims, cost, liabilities, expenses or judgment arising out of my participation/my child’s or ward’s participation in the school’s programs or any illness r injury resulting there from. I have read and understand the Liability/Medical Release, Tuition Policy and Makeup Policy.         Signature of Parent/Legal Guardian Date