Dancer 1 name *

First Name

Last Name

Dancer 1 DOB: *

MM

DD

YYYY

Dancer 2 name

First Name

Last Name

Dancer 2 DOB:

MM

DD

YYYY

Dancer 3 name

First Name

Last Name

Dancer 3 DOB:

MM

DD

YYYY

Parent / Guardian *

First Name

Last Name

I'm interested in classes: *

1X a week

2X a week

3X a week

My dancer is:

Registration fee due with September's payment, thank you.

Returning student: $10/family registration fee. (No T-shirt included.)

NEW Summer / Fall '23 student: $20/family registration fee + black Jamieson T-Shirt!

Adult student: No Registration fee necessary.

Waiver to participate *

I agree not to hold Katie Jamieson and / or Jamieson Irish Dance liable for any injury, accident or loss while participating in any dance activity. If injury occurs, I understand that medical bills & other inconveniences of the injury will be handled by the parent / guardian. I also confirm that my child / children are of healthy standing & are permitted to participate in Dance / exercise. I understand how sicknesses / viruses are contracted & am fully aware of the risks associated in dance class environment. I will not hold Katie Jamieson and / or Jamieson Irish Dance liable for any sickness / virus contracted at any time. Prior to arriving to class I have assessed my dancer's health & observed for any symptoms-if feeling ill, my dancer(s) will stay home. I understand all terms regarding payments & agree to make payments by scheduled dates or pay the appropriate late fees. If a check is returned a $25 fee will be added. There will be no refunds if a student misses class regularly. If a student would like to leave the dance school a 30 day notice should be given in writing, otherwise monthly charges will continue, Thank you.

Yes

Social Media Waiver *

I approve the use of photographs of my child/children to be used in an dvertising manner, ie: website, pamphlets, Social Media posts, etc.

Yes

No