O'Shea Irish Dance, Minneapolis and St. Paul, Minnesota

O'Shea Irish Dance Registration


* required field

Age, date of birth, and parent/guardian names required for students 21 & under.

*Date:

*Student's Name:

Gender: (M)   (F)

Registering for:
Weekly Class: Location:
Summer Camp:

School:
Grade Level:
Date of Birth:
Age:

Parent/Guardian's Names:

*Street Address:
*City: *State: *Zip:

*Home Telephone: Cell Phone:
*Email:

Second Home Information (optional)
Parent/Guardian:
Street Address:
City: State: Zip:
Home Telephone: Cell Phone:
Email:

Emergency Contact Name & Relation:
Emergency Contact Home Telephone:
Emergency Contact Cell Phone:

Please list other physical activities you participate in:


How did you hear about us?


RETURNING STUDENTS:
Please list most recent class level:

*I have read the Policies and Procedures and Release Agreement documents, and hereby agree to abide by the rules and regulations contained therein.

O'Shea Irish Dance, LLC reserves the right to cancel a class if enrollment is less than 5 students per class.

For reference, here are our Policies and Procedures (PDF), Release Agreement (PDF), and Tuition Structure (PDF).



Copyright © 2007-2010 O'Shea Irish Dance