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MPG Irish Dance 2022 Summer Camp Registration Form
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* Indicates required question
Name of Student
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Address
Your answer
Guardian's Name
*
Your answer
Email Address
*
Your answer
Contact Telephone Number
*
Your answer
Any health issues you want your dance teacher to be aware of?:
*
Your answer
What method of payment will you be using to pay Summer Camp registration? (Payment will not be made in this form)
*
Choose
Cash
Check
Zelle
Venmo
Paypal
Occasionally, MPG Irish Dance shares photos and videos of school events on the website, Facebook and other social media outlets for advertising purposes. Do you consent to having your child's image shared in this way?
*
Yes
No
Name of person completing this form
*
Your answer
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