REGISTRATION FORM 2008/2009

I wish to enroll the following dancer(s) for the 2008-2009 school year.   LOCATION_________________

 

_____one class per week  _____two classes per week   ________________ dance level ____________ day

 

__________St. Patrick's Day class _______________ Ceili Class         (Feis/Drills class open)

 

DANCER 1   NAME: ______________________________ DATE OF BIRTH:_____________________

 

DANCER 2   NAME: ______________________________ DATE OF BIRTH:_____________________

 

DANCER 3   NAME: ______________________________ DATE OF BIRTH:_____________________

 

STREET ADDRESS:_______________________________________________________

 

CITY:____________________________STATE:____________________   ZIP CODE:_______________

 

HOME PHONE #:______________________                CELL PHONE #____________________

 

ALL CORRESPONDENCE, CANCELLATIONS, ETC. WILL BE SENT BY EMAIL.   PLEASE PROVIDE YOUR CORRECT EMAIL ADDRESS WHERE YOU WISH TO GET ALL IMPORTANT CLASS INFORMATION.

EMAIL ADDRESS:___________________________________________________________________

PLEASE PRINT CLEARLY

 

Please state any medical condition/medications your child has that you would like us to be aware of or any other information you feel is important for us to best assist your child: __________________________________________________________________

 

______________________________________________________________________________________

 

IF YOU ARE A TRANSFER STUDENT, PLEASE INCLUDE NAME OF DANCING SCHOOL:

______________________________________________________________________________________

Please include a $25.00 transfer fee with registration form.

 

I agree to abide by the terms spelled out herein and in the registration letter.  I understand that being offered a monthly payment plan is a courtesy extended to me and that I am responsible for all payments from September, 2008 through and including June, 2009 (whether I attend class or not) *.  This represents a total of ten monthly payments, each due the first week of the month.  A non-refundable registration fee of $25.00 per family is enclosed with this registration form. 

 

 ALL FEES ARE NON-REFUNDABLE.  Late fees as explained will be enforced.

 

Parents should be aware that dancing is considered to be an athletic activity and inherent to this, various injuries such as, but not limited to, sprains, breaks, muscle pulls, blistering, etc. may occur.  The Woods School of Irish Dance will not be held responsible for any injuries incurred.

 

SIGNATURE OF PARENT OR GUARDIAN:________________________________________

 

PRINT PARENT NAME:___________________________________DATE:________________________