All Belly dance, belly dancing classes are taught in Downtown Houston, TX.
Group and private lessons available. Contact Gabriela Belly dancer to
bellydance@artbygabriela.com

Modern Belly Dance by Gabriela
Your  full name:
Your email address:
Your phone number:
Registering for:
Belly Dance Basics ~ Saturdays noon-1 pm ~ Cost: $50  (4-week session, 1 class per week)
Release of liability:
I hereby certify that I’m in good health and in proper physical condition to participate in Gabriela’s belly
dance classes. I understand that belly dancing may be physically demanding and strenuous, therefore
it is recommended that I consult with a physician before beginning this program. I release the instructor
and Barnevelder Movement Arts Complex from any and all responsibility and liability, from any risk,
bodily injury, physical or other disability, which results or may result from my participation in these
classes.

I AGREE AND ACCEPT THAT I HAVE READ AND FULLY UNDERSTAND THE ABOVE STATEMENT. BY
SUBMITTING BELOW I RELEASE THE INSTRUCTOR FROM ALL RESPONSIBILITY AND LIABILITY
RELATED TO MY PARTICIPATION IN THIS PROGRAM.
Note: By submitting this form you're reserving your spot only. You can choose to pay online with credit card
in the next step, or pay when you 1st come to class in cash or personal check.
All classes are held at Barnevelder Movement/Arts Complex
2201 Preston at Hutchins,  77003