7th & 8th Grade Dance Permission Slip

Name*

First

Last

Email*

Phone*

Number of Interested Students*

Program(s) of Interest*

Student 1 Name*

First

Last

Student 1's Grade of Interest*

Student 1's Birthdate*

Student 2 Name

First

Last

Student 2's Grade of Interest*

Student 2's Birthdate*

Student 3 Name

First

Last

Student 3's Grade of Interest*

Student 3's Birthdate*

Student 4 Name

First

Last

Student 4's Grade of Interest*

Student 4's Birthdate*

Address*

Street Address

Address Line 2

City

State / Province / Region

ZIP / Postal Code

Country

Is any parent or guardian an alumnus/a of the Waldorf School of Garden City?

Please state the full name and class year of any alumni:*

Additional Info or Questions

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