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MidMo Conservatory of Dance Party Waiver
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* Indicates required question
Birthday Party Host's Name
*
Your answer
Participant Name
*
Your answer
Parent or Guardian Name
*
Your answer
Parent or Guardian phone number
*
Your answer
Parent or Guardian email address
Your answer
By typing your name below you agree to hold Jennifer Winkelman, MidMo Conservatory, and it's Staff harmless from injuries and losses.
*
Your answer
By registering you are giving MidMo Conservatory of Dance permission to use party pictures of you and your child in advertisements for parties. If you do not want your child photographed , please check here.
*
I give permission for my child to be photographed
I do not give permission for my child to be photographed
Date siged.
*
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YYYY
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