BELLY DANCE FOR ADULTS
8 WEEK COURSE
Starts
August 18th
Get Ready & Shape Up !
8 WEEK BELLY DANCE FOR ADULTS
Get ready & shape up for Fall!!!

W
ednesdays, August 18th - October 6th
7:15 - 8:15 p.m.

$80.00/SESSION

Please wear comfortable clothes and bring a water bottle.
Please send the following form with payment by A
ugust 15th to:
The Medway Dance Authority P.O. Box 150 Medway, Ma 02053


Name _______________________________________

Address______________________________________

Phone____________________ Cell________________

Email________________________________________

Please enclose payment with form - Thank You!



Risk of Injury Waiver

I, ______________________________________, will participate in Belly Dance.
I understand that as with any form of exercise or physical activity there is risk of
injury.  I will not hold The Medway Dance Authority or it’s representatives
responsible for any injury during this program.  

Signature  _________________________     Printed Name ______________________

Date  _____________