Last Name     

McGinley School of Irish Dance

Registration Form 2007-08

 

Parent's Names     

             Address     

           City/Town     

            Zip Code                                       

     Home Phone     

    

     Work Phone       (Mom)

     Work Phone       (Dad)

       

        Cell Phone       (Mom)

        Cell Phone       (Dad)

 

              E-mail           

                                

 

Dancer's Name                 Dancer's Name     

                     Age (As of 9/1/07)                                   Age (As of 9/1/07)      

            Birthday                              Birthday     

 

Dancer's Name                 Dancer's Name     

                   Age (As of 9/1/07)                                   Age (As of 9/1/07)       

             Birthday                             Birthday     

 

Check Here if there are changes from last year (or if you are new to the school).  _________           

        

I verify that the above information is correct.  By signing, I also acknowledge that I have read and understand the payment terms and conditions.

 

Signature:  __________________________________

        Date: ______________

 

Copyright © 1999 [McGinley School of Irish Dance]. All rights reserved.
Revised: September 19, 2007