Students Name *

First Name

Last Name

Parents Name *

First Name

Last Name

Contact Phone *

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Liability *

I have read and understood all tuition information and rules. I herby waive any claim of liability on behalf of the Ballet Academy in Lincoln Park, Alphonsus Academy, DePaul University, Ray Mayer Center or it’s personnel or officers for any injury or for efforts to obtain treatment for my child in event that I or my representative cannot be reached.