Bethlehem Traditional Irish Dance 2025-2026 Registration
Please fill out a separate form for each dancer
Schedule -- Classes begin September 10th 2025
Please note: Current dancers, you should have received an email letting you know your class level.
Student Information
Note -- if filling out for a sibling, just name, age and gender/health and select the course. Only fill out address and parent/emergency contact on one form.
Name
First Name
Last Name
Age
*
Gender
Male
Female
Phone Number
-
Area Code
Phone Number
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Let us know if you/your child has any health concerns or other restrictions we should know about:
Parent/Guardian Information
For minors (below 18 years of age)
Parent/Guardian Name
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Email
example@example.com
Relationship
Choose classes below
Select your class below
PreK 4 -Kindergarten Intro to Irish Dance
New Beginners 7 and up (Saturday)
Beginner/Primary 1
Experienced Beginners
Advanced Beginners
Primary 2
Intermediate 1
Intermediate 2
Advanced 1
Advanced 2
Senior advanced
Adults
Policies and Procedures
Signature of Student
Date Signed
-
Month
-
Day
Year
Date
Policicies and Procedures
Parent/guardian Name
First Name
Last Name
Parent/guardian Signature
Date Signed
-
Month
-
Day
Year
Date
Submit
Print Form
Should be Empty: