Registration
& Tuition

Dancer Name *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Beginner I, Ages 3.5-6

Thursdays 5:30-6:15PM (45min)

Saturdays 11:00-11:45AM (45min)

Beginner II, Ages 6+

Thursdays 6:00-6:45PM (45min)

Saturdays 11:45-12:30PM (45min)

Intermediate

Thursdays 6:30-7:30PM (60min)

Saturdays 11:45-12:30PM (45min)

Advanced

Tuesdays 7:00-8:00PM (60min)

Thursdays 6:30-7:30PM (60min)

Saturdays 12:30-2:00PM (90min)

Adults

Tuesdays - Ceili Madness 7:30-8:30PM (60min)

Tuesdays - Int./Advanced 8:30-9:30PM (60min)

Thursdays - Int./Advanced 7:30-9:00PM (90min)

Saturdays - Oireachtas Only 12:30-2:00PM (90min)

Primary Contact Name

First Name

Last Name

Phone *

(###)

###

####

Home Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Terms of Service *

I am the participant OR am the parent or legal guardian of the participant listed above, and I have authority to sign agreements and make decisions on the participant’s behalf. I hereby agree to indemnify and hold harmless 'O'Donnell Irish Dance', dba O'Donnell Academy, all classes, camps and programs associated with these entities, and their officers, contractors, and employees (collectively “O'Donnell Academy”), from and against any and all liability for any injury, contraction of an infectious disease or virus, or death which may be suffered by me or my child, arising out of, or in any way connected with participation in programs at the O'Donnell Academy. In case of emergency, my child may be treated by a qualified physician. I agree not to bring my child to the O'Donnell Academy class or camp if either of us is sick or is suspected of carrying an infectious disease or virus. The O'Donnell Academy may ask my child health questions if my child exhibits any signs or symptoms of being unwell at any time during the program. I understand that there may be video or photographs taken of my child during their class, and I grant permission for this media to be used in faculty training and/or promotional advertising for the O'Donnell Academy, without compensation. I waive all rights of publicity on behalf of my child in connection with the use of this media to promote the O'Donnell Academy. I understand that I may speak to an O'Donnell Academy staff member and request that my child be excluded from any photographs or videos, and that I may request digital copies of any media in which my child appears that is used by the O'Donnell Academy for promotional purposes. In submitting this form I agree to pay any applicable tuition or fees. In signing and submitting this form, I agree to the terms of service above.

I agree to the above terms