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MidMo Conservatory of Dance Party Waiver
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Birthday Party Host's Name *
Participant Name *
Parent or Guardian Name *
Parent or Guardian phone number *
Parent or Guardian email address
By typing your name below you agree to hold Jennifer Winkelman, MidMo Conservatory, and it's Staff harmless from injuries and losses. *
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. *
Date siged. *
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