Dance Creations Dance Studio
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1401 E. Cottonwood St.Springfield, IL. 62703 |


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I do hereby release Janet Cripe of Dance Creations Dance Studio and it's Staff from any liability occurring on or around studio premises, or at any function held at other locations in connection with the dance classes in which the student named above is/are enrolled. I declare that the student named above is/are in good health and can participate in dance education classes. Given the nature of the classes, and with the knowledge that injuries sometimes might occur, I have taken the proper steps to obtain accident, health, or hospitalization insurance, which would cover any sustained injury. In the event of an injury or emergency when I cannot be contacted, I give my permission for you to obtain medical services for the student named above.
Janet Cripe and DCDS may have my permission to publish photo(s) of my Child for any publication representing DCDS, including the school website.
(registration is not complete without this authorization)

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