Name of Student(s)                                 Age:               Birthday:         Classes & Times:

1.____________________________          ________              _________       _____________________

2.____________________________          ________              _________       _____________________

3.____________________________          ________              _________       _____________________

4.____________________________          ________              _________       _____________________

Address:______________________________         Phone#:____________

City:____________________Zip:____________

Parent’s Names:________________________________ Work#_____________________

I agree to let the students listed above participate in dance lessons at Sharri’s School of Dance , Inc. in Waseca.  I agree to pay all fees incurred at the studio.  I agree that the above listed will participate in the dance recital and mandatory rehearsals.  I also agree to let the studio use dance pictures for publicity purpose.  If I choose to stop taking a class for any reason except moving out of town, I must notify the studio before the 6^th week of the new dance year.  If I choose to quit a class after that 6 week period, I will pay the remaining tuition until May 2008.  I Understand that there are no refunds for dance lessons, even for missed classes.  I understand that Sharri’s School of Dance does not have medical insurance for it’s students and is not responsible for accidents.

Parent’s signature:________________________________________________

How did you hear about Sharri’s School of Dance ?_____________________________