PARENT & GUARDIAN’S APPROVAL AND STUDIO RELEASE FOR STUDENTS 12 & UNDER

I give permission to All That Jazz Dance Academy to release my child from their premises after class without parental supervision. I agree and acknowledge that once my child leaves their premises, All That Jazz Dance Academy is no longer responsible for the care of my child. I hereby waive and release All That Jazz Dance Academy and all teachers, instructors, volunteers and employees from any and against all claims of liability.

Parent/Guardian's Full Name*
*Parent/Guardian's Full Name:
First Name Last Name
Student's Full Name*
*Student's Full Name:
First Name Last Name
Date*
*Date:

Day
Month
Year
Signature*
Signature*
Phone
This field is for validation purposes and should be left unchanged.

First Name	Last Name