Tammy's School of Dance, Wexford, PA 15090

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You can submit your registration online or print our registration form
and mail this along with your September tuition and registration fee to
Tammy's School of Dance, 10994 Perry Highway, Wexford, PA 15090.

Information about your dancer

First name*:
Last name*:
Address:
City:
State:
Zip Code:

Birthdate*:
Grade*:
Dance experience:	(years)
	(where)

Registration for

Classes*:	(e.g. tap, ballet)
Day*:	(Monday or / and Friday)
Time (from - to)*:	(e.g. 4:30 - 6:00 pm)

Parent/Guardian Information, Emergency contact

Parent/Guardian*:
Phone*:
Cell Phone:
E-Mail Address*:
Emergency Contact*:	(Other than parent)
Phone*:	(Other than parent)

Please read the following paragraphs carefully and check off

	HOLD HARMLESS CLAUSE I, the parent or guardian of the registrant, a minor intending to be legally bound hereby agree to indemnify and hold harmless, Tammy’s School of Dance, its members and its contracted instructors, from any and all liability for personal injuries and personal property damage or loss in connection to the dance lesson program at 10994 Perry Highway, Wexford, PA.

	CONSENT FOR MEDICAL TREATMENT As the parent or guardian of the registrant, I hereby give my consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb, or well being of my dependent. I agree to the Dance School policies, Hold Harmless Clause, and Consent for Medical Treatment as stated above.

	I give TSD the permission to use my child’s photo in print or on TSD website.

Question or comment: