A Cinderella's Dream

Sewing, Crafts & Embroidery for children and 18"Dolls.

Student's Name __________________________________________________________________
                                    Last                                  First                            MI
Address  ___________________    City _____________ State ____ 

Zip Code _____

Date of Birth:  ___________  Male  / Female     Grade _______  Age ________

Parent/Guardian/Name  ________________________Phone ______________  

email:  _______________________________ Cell _______________________

Emergency Contact: Name _______________________

Phone ________________

Enrollment Agreement
1) The students will receive instruction, guidance, and encouragement.
2) The sponsor (A Cinderella's Dream-Camp/Class Director) reserves the right to

    dismiss any student whose conduct proves not to be in harmony with the camps'

3) A Cinderella's Dream reserves the right to cancel or alter any scheduled course if

    necessary. If a course is canceled, camp, class or workshop fees will be refunded.
4) I understand that no camp, class or workshop fees will be refunded once class starts.
    If you cancel a class, we will reschedule your time.

5)  A non-refundable fee of $25.00 is required to reserve your space.

     The balance of camp, class or workshop will be due on or before the first day of instruction.

Parent/Guardian/Self Signature  ________________________  

Date  ___________

Medical Release & Waiver Agreement
I agree to release and hold harmless A Cinderella's Dream, and it's instructor's from any

and all losses, liabilities, claims, and expenses that may occur as a result of my child/myself 

participation in any camp, class or workshops.

Emergency Name and Phone #:  _________________________________________ 

Physician's Name: ___________________________ 

 Phone #:  _________________
Special Needs:  _______________________________________________________
Known Allergies:  _____________________________________________________ 

Current Medications: ___________________________________________________

In the event of an accident or injury to my child, I hereby give my consent for

A Cinderella's Dream director and staff to arrange medical treatment for my child/myself 

in the event I cannot be reached. I understand that I will be financially responsible for any

medical treatment or service given to my child/myself.

Parent/Guardian Signature:  _________________________  

Date:  ___________

Photo/Video Waiver
I give A Cinderella's Dream permission to use photos taken of my child/myself during camp, 

or class for publication of its website and or for advertisement purposes only.  ___Yes  ___ No 

We will not use any names.

Parent/Guardian Signature:  __________________________ Date:  _________


Cost: __________ Payment: __________ Balance Due: __________  Check # ___________

Please copy and mail in to: A Cinderella's Dream. P.O. Box 924912 * Houston, Texas  77292-4912.