| BELLY DANCE FOR ADULTS with Tara Termini Get Ready & Shape Up ! |
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| BELLY DANCE FOR ADULTS Get ready & shape up!!! Wednesdays 7:15 - 8:15 p.m. $10.00 PER CLASS Please wear comfortable clothes and bring a water bottle. Please BRING the following form with payment 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 _____________ |