Free photo release form 51Free photo release form 51
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Important Information
& Photo Release Form
Studio Use Only
Class/Day/Time:_______________
Tuition/Billing:________________

Dancer Information:
Child
Child
Child
Child

1:
2:
3:
4:

Last
Last
Last
Last

Name:__________________________
Name:__________________________
Name:__________________________
Name:__________________________

First
First
First
First

Name:____________________
Name:____________________
Name:____________________
Name:____________________

M.I.:_______
M.I.:_______
M.I.:_______
M.I.:_______

Street:____________________________________________________________________________________
City:________________________________________ State:___________ Zip:________________________
Child
Child
Child
Child

1:
2:
3:
4:

Age:________
Age:________
Age:________
Age:________

DOB:_____________
DOB:_____________
DOB:_____________
DOB:_____________

IMPORTANT – Keep Informed!
E-mail Address:__________________________________________________ (Please PRINT Clearly)
Parent/Guardian Info