Mise Eire Irish Dancers Registration 2022-2023
ONE form PER Dancer
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Email *
Dancer's First Name *
Dancer's Last Name *
Dancer's Date of Birth *
MM
/
DD
/
YYYY
E-mail Address *
ADDITIONAL E-Mail Address Optional (Ex: Dancer's Email/ Spouse Email)
Parent/Guardian Name(s) *
Street Address *
City *
State *
Zip *
Parent/ Guardian Cell Phone Number *
ADDITIONAL Parent/ Guardian Cell Phone Number (Optional)
Allergies *
Choose Your Dancer's Class(es) *
Required
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