Free Trial Class - Registration Form
If you sign up for a free trial class and cannot make it, simply submit another form with a new date selected!
Sign in to Google to save your progress. Learn more
Email *
Student First Name *
Student Last Name *
Student Age *
Parent Name - First & Last *
Parent Phone Number
We would like to try the following Fall Session class (please select one):
Pre-School (Ages 3-5), Thursdays, 5:00-5:45 pm
New Beginner (Age 6 +), Thursdays, 5:45-6:30 pm
September 9, 2021
September 16, 2021
September 23, 2021
September 30, 2021
October 7, 2021
October 19, 2021
October 28, 2021
November 4, 2021
November 11, 2021
November 18, 2021
December 2, 2021
December 9, 2021
December 16, 2021
December 23, 2021
January 6, 2022
January 13, 2022
January 20, 2022
January 27, 2022
February 3, 2022
Clear selection
I have the following questions and/or comments:
By checking this box and submitting this registration, I grant permission for the above-named student to participate in dance instruction and activities provided through Ni Riain School of Irish Dance. I further agree to indemnify and hold harmless Ni Riain School of Irish Dance and each of their officers, independent contractors, leaders, teachers and volunteers from any and all liability and expenses with respect to claims for all damages or losses that may be asserted by their participation in instruction and activities conducted by Ni Riain School of Irish Dance. I acknowledge that medically trained staff is not available during classes and activities, and that I am responsible for monitoring any health issues that my child may have during these times and provide care and attention as needed. I verify that all information on this form is true and correct, agree to update the information as needed. If I choose to continue as an enrolled student, I will fill out a Student Registration and any related forms. *
CRN Covid-19 Liability Waiver (as needed) By checking this box and submitting this registration, I acknowledge the contagious nature of COVID-19 and I assume the responsibility that my child(ren), myself or my family may be exposed to, or infected by COVID-19 while attending Ni Riain School of Irish Dance and that such exposure or infection may result in, illness, permanent disability or death. I understand that the risk of becoming exposed or infected by COVID-19 may result from actions, omissions or negligence of myself or others, including but not limited to Ni Riain School of Irish Dance, instructors, volunteers, dancers and their families.I voluntarily agree to assume all the risks and accept sole responsibility of being exposed or infected by COVID-19, to myself, dancer(s) or family which may occur while attending the Ni Riain School of Irish Dance. I hereby release, covenant not to sue, discharge, and hold harmless the Ni Riain School of Irish Dance, instructors, volunteers, dancers and their families of any form of claims, actions, damages, costs or expenses of any kind arising from, out of, or relating thereto. I understand and I agree to this release whether COVID-19 infection occurs before, during, or after participation in any Ni Riain School of Irish Dance classes or activities. I agree that the person submitting this form is 18 years or older, or the parent of the dancer registering. *
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Ni Riain School of Irish Dance. Report Abuse