Shovlin Academy of Irish Dance Registration: September 2017 - May 2018
REGISTRATON DETAILS:
• Classes begin Mon., September 11th or Wed., September 13th, depending on your class
• Deadline September 1st
• Registration form is required for each student
• Tuition due 1st day of class
• Dancers choosing 3 payment plan below, 2nd & 3rd payments are due 12/1 and 3/1

STUDIO LOCATION:
Dormont Municipal Building, Dormont, PA 15216

DIRECTIONS:
http://shovlinacademy.com/location.php

CLASS SCHEDULE (includes dates off)
http://shovlinacademy.com/schedule.php

PAY BY CHECK:
Kindly submit payment and make checks payable to:
Shovlin Academy of Irish Dance
c/o 820 Parkside Avenue, Pittsburgh, PA 15228

PAY BY CREDIT CARD:
http://shovlinacademy.com/registration.php

Registration Form 2017-2018
Classes:
• All new dancers are enrolled in Beginner Class.
• Enrollment for other classes are by teacher invitation (current students see registration email).
Registration - Required for each student
• Registration Form and Fee due by September 1st.
• Tuition is due 1st day of class.
Registration Fee/Tuition (indicate choice of tuition plan)
PAY BY CHECK:
Kindly submit payment and make checks payable to:
Shovlin Academy of Irish Dance
c/o 820 Parkside Avenue, Pittsburgh, PA 15228

PAY BY CREDIT CARD:
http://shovlinacademy.com/registration.php

Registration Fee - $15 per student due with registration (non-refundable) *
Tuition - 3 payments/1 class per week
Tuition - 3 payments/2 classes per week (Novice/Open)
Tuition - Full year (1 pymt.)/1 class per week
Tuition - Full year (1 pymt.)/2 classes per week (Novice/Open)
Class Registration - Mondays Only
Class Registration - Wednesdays Only
Class Registration - Both Mondays & Wednesdays
Student's Name (First & Last) *
Your answer
Student's Date of Birth *
Your answer
Parent/Guardian Full Name #1 *
Your answer
Parent/Guardian Full Name #2
Your answer
Email Address (to receive all dance school info) *
Your answer
Additional Email Address
Your answer
Street Address *
Your answer
City/State/Zip *
Your answer
Home Phone Number
Your answer
Mobile Phone Number *
Your answer
Refund Policy
The Registration Fee is non-refundable. Only those classes that take place after the School is contacted about a student's withdrawal will be refunded (i.e., past-tense missed classes will not be refunded). Any discounts will no longer apply. Students withdrawing will be refunded money paid minus $17 per student per class for those classes that have taken place prior to the point of formal withdrawal.
Release/Waiver
I am the parent/guardian of this student and hereby request that he/she be permitted to engage in Irish Dance class, utilizing facilities owned, operated and/or maintained by Dormont Municipal Building, Pittsburgh, PA. I expressly acknowledge and recognize that participation in said dance activities creates a rise of injury to person or property and hereby expressly release, remise and forever discharge the class instructors and their assigns, Dormont Municipal Building, Pittsburgh, PA and its officers, agents and employees from any liability for any and all claims, suits or causes of action arising from injuries to the person or property of the student named above as a result of his/her use of recreational facilities owned, operated and/or maintained by Dormont Municipal Building, Pittsburgh, PA.

My submission of this registration confirms that this student does not have any pre-existing medical condition that would prohibit or limit their full participation in his/her class curriculum. Should my child/this student have a pre-existing medical condition that would limit or prohibit his/her full participation in his/her class curriculum, I will provide written medical clearance from his/her primary care physician prior to admittance as a student of the Shovlin Academy of Irish Dance.

I have read this release and intend to be legally bound by submission of this registration.

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