* Required

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.​​​