& HIP-HOP MASTER CLASS!


Come join the fun Saturday July 15th, 11:00-2:00    3rd grade and up!!   Price is $35/dancer


                                                                              PLEASE SIGN AND DATE WAIVER


          I Understand that the dance instruction given to my child,_______________________,is a vigorous

Physical activity which may result in injuries to my child.  In consideration of the enrollment of my child,

I hereby release the owners, directors, employees, affiliates and agents of The Lori Allen Dance Center

And the owners of the premises upon which any class, rehearsal or any performances is held from any

And all causes of action, claims for damages and expenses related to or arising out of any accident, injury

Or loss of property related to my child’s instruction or participation in any activity related to the

Lori Allen Dance Center.


 Signature______________________________     Date_______________

                                        Parent or legal guardian


Relationship to student_________________________________________


PHOTO DISCLAIMER:  I give the Lori Allen Dance Center permission to use my daughter’s/son ‘s photo

On any social media site or Lori Allen Dance Center website  Strictly for advertising.          YES OR NO


   Emergency Name and Number  _____________________________________           EMAIL:___________________________________

Where Children Can Reach Their Goals and Fulfill Their Dreams