*
Required
Student Name
*
required
Age
*
required
Parent Name
*
required
Address
*
required
City
*
required
State
*
required
Zip
*
required
Email
*
required
Phone
*
required
Camps*
Intermediate and Advanced Nutcracker Prep I Ages 13 and up I August 1-4 I 10 a.m.-2 p.m. ($275)
Musical Theater Dance Intensive I Ages 8 and up I July 18-21 I 10 a.m.-2 p.m. ($225)
Release of Liability*
I hereby release Buckman Fine Arts Center, St. Mary’s Episcopal School, Mandy Possel, Steven Prince Tate, and Cindi Younker of any liability for accidental injury caused by acts of self or other students attending these dance classes, rehearsals and performances. The undersigned expressly consents to acceptance of all responsibility for any injuries that might occur. Additionally, the Buckman Dance Conservatory has my consent to publish any photos taken of student. Classes meet in the dance studio of Buckman Arts Center. See buckmanartscenter.com for details.
I Agree to the Release of Liability above.*
TOTAL PAYMENT
*
required
Please send a confirmation email to the address below*: