Fall 2008 Registration and Payments due by Sept 3rd, 2008
McNulty School of Irish Dance – Class RegistrationInstructions: / Print out this form & complete entirely. Make checks payable to: Barbara McNulty
Mail both pages and payment to: / Barbara McNulty
8640 W. Sunset Road, Niles IL 60714
***Contact Park District for classes offered through park district.***
Session: / Fall ‘08 / Classes Begin:
See schedule / Sept.
2008 / Registration Deadline: / Sept 3rd
Last Name: / Ph: / Email:
Address: / City, State, Zip
Parent/Guardian Last Name:
Student’s Name: / D.O.B.
Class Location: / Day/Time: / Fee:
Class Location: / Day/Time: / Fee:
Student’s Name: / D.O.B.
Class Location: / Day/Time: / Fee:
Class Location: / Day/Time: / Fee:
Student’s Name: / D.O.B.
Class Location: / Day/Time: / Fee:
Class Location: / Day/Time: / Fee:
Less discount (see below):
Parent Club Fee (new this year) / $20.00 per family yearly
Optional> / + New student CD ($8 each):
Optional> / Practice CD Music Only ($20):
Total due:
Discounts: / Families with 3 or more children enrolled in the same session are eligible for a 10% discount on the total tuition due. The fifth family member enrolled is FREE. Parents enrolled in an adult class during the same session as their child/children receive a 50% discount on the adult class fee if the class meets the 8 min requirement of full payment participants or combined. FULL TUITION must be paid prior to the first class of a session in order to qualify for any discounts. 1 discount per family
Notes: / To enroll in a heavy shoe class, you must also enroll in a soft shoe class during the same session.
You will not receive a confirmation of registration. We will contact you ONLY if the class for which you’ve registered is canceled or changed.
Check class schedule for other eligibility requirements, fees, dates, and deadlines.
Class attire: T-shirts, shorts, socks and shoes (Irish, jazz, ballet or light gym shoes). Leotards with shorts over them are acceptable. NO long pants of any kind.
Group classes not available to anyone teaching Irish dance outside the McNulty School of Irish Dance. Please contact us to arrange private lessons.
NO REFUNDS AFTER 1st CLASS OF THE SESSION $15 service charge for NSF checks.
LATE FEE of $15 per class for any class not paid in full by 1st Class, unless arrangements have been made with office.
Dance is Music Made Visible
Fall 2008 Registration and Payments due by Sept 3rd, 2008
McNulty School of Irish Dance
Release and Hold Harmless Agreement
This form must be completed and returned to Barbara McNulty Heneghan prior to participation in any activity with The McNulty Irish Dancers, including but not limited to performances.
Please read this form carefully and be aware that in signing up and participating in this program(s), you will be waiving and releasing all claims for injuries you might sustain arising out of this program(s).
As a participant in this program(s), I recognize and acknowledge that there are certain risks of physical injury and I agree to assume the full risk of any injuries, damages or loss which I may sustain as a result of participating in any and all activities with or associated with such program(s).
I agree to waive and relinquish all claims I may have as a result of participating in the program(s) against Barbara McNulty Heneghan, the McNulty School of Irish Dance, its teachers, officers, agents, servants, and employees.
I do hereby release and discharge Barbara McNulty Heneghan, the McNulty School of Irish Dance, its teachers, officers, agents, servants, and employees from any and all claims from injuries, damage, or loss which I may have or which may accrue to me on account of my participation in the program(s).
I further agree to indemnify and hold harmless and defend Barbara McNulty Heneghan, the McNulty School of Irish Dance, its teachers, officers, agents, servants, and employees from injuries, damages and losses sustained by me and arising out of, connected with, or in any way associated with the activities of the program(s).
I have read and fully understand the above program details and waiver and release of all claims.
Participant’s Name: ______Phone: ______
Participant’s Name: ______
Participant’s Name: ______
Participant’s Name: ______
Address: ______
City/State/Zip: ______
Class Location: ______
Participant’s signature (or guardian’s signature if participant is a minor).
Signature: ______Date: ______
Dance is Music Made Visible