Janelle’s Irish dance
Fall 2011 Class registration
(Office USE)
STUDENT class Day STUDIO Time
___
___
___
TOTAL FAMILY FEE: $________________ (+ $10 Registration Fee)
paid in full: $ __________ date:______ ____ (CIRCLE) cash/Check #: _____
1st PAYMENT: $___ ____ date: __ (CIRCLE) cash/Check #: _____
2nd PAYMENT: $___ _____ date: __ (CIRCLE) cash/Check #: _____
------------------------------------------------
parent’s names ___________________________________________________________
address _____________________________________________________________________
home phone _____________________ cell phone _______________________
email________________________________________
STUDENT age/dob grade SCHOOL/TIME DISMISSED fee
___
___
___
SEMESTER class fees: FAMILY DISCOUNT: 3+ CHILDREN...
registration: $10/family AFTER TWO FULL-PRICE ENROLLMENTS,
1-hr class: $90 DEDUCT $10 Off EACH additional FEE!
45-min class: $85 (POLICY nOTE: INDIVIDUAL ADJUSTMENTS
30-min class: $80 CAN BE WORKED OUT ACCORDING TO
private class: $16/hr family FINANCIAL SITUATIONS...)
------------------------------------------------
aS PARENTS & STUDENTs, WE DO HEREBY:
COMMIT ourselves TO SUPPORT janelle’s irish dance goals &
commitment to both personal & class: instruction; skill
development; & codes of modesty, respect, & discipline...
ACCEPT Any LIABILITY FOR POSSIBLE ACCIDENT, INJURY, damage ON
DANCE PREMISES...
authorize the use of PICTURES TAKEN FOR PROMOTIONAL PURPOSES
For jANELLE’S IRISH DANCE.
PARENT SIGNATURE: ______________________________________________________
dATE: ___________________