Mulvihill-Lynch Irish Dance Registration
2019/2020 REGISTRATION YEAR

REGISTRATION FEES:
$35.00 ONE DANCER
$70.00 TWO DANCERS
$100.00 THREE DANCERS

Tuition Fees are outlined in the registration packet which was e-mailed.

ONE form PER child

Child's First Name *
Your answer
Child's Last Name *
Your answer
Child's Date of Birth *
MM
/
DD
/
YYYY
Child's Age on September 1, 2019 *
Contact E-mail Address (please check spelling!) *
Your answer
Additional E-Mail Address (if different than above - Optional)
Your answer
Parent/Guardian Name(s) *
Your answer
Street Address *
Your answer
City *
Your answer
Zip Code *
Your answer
Parent/Guardian Cell Phone Number *
Your answer
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