Form
Dancer’s Name
First Name
Last Name
Date of birth
-
Month
-
Day
Year
Date
Parent’s Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Emergency Contact
First Name
Last Name
Emergency Phone Number
Please enter a valid phone number.
Location
Please Select
Kanturk
Charleville
Class type
Please Select
Beginner/grades
Open
Available Day
Monday: Kanturk (beginner / adv. beginner / open)
Tuesday: Charleville (beginner / adv. beginner / open)
Thursday: Charleville (adv. beginner / open)
Friday: Charleville (Open Championship)
Submit
Should be Empty: