WELCOME TO THE CARA SCHOOL OF IRISH DANCE
5126 State Road, Drexel Hill, PA 19026
email: info@caraschool.com
under the direction of:
Margaret Roche
Grant TCRG Maureen Murray Hegarty
TCRG Annmarie Murray Sheehan TCRG
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Please PRINT all info.
Dancer’s Name ________________________________________
Parent/Guardian name ________________________________________
Address ________________________________________
Phone ________________________________________
Date of Birth ________________________________________
Email Address (field must be completed)
________________________________________
Emergency Contact Name: ________________________________________
Emergency Contact Number: ________________________________________
Primary
location (check one)
Drexel Hill
Monday ____ Drexel Hill Friday___ Drexel Hill Saturday____ Edgemont Wed.___ Oxford
Friday ____ Parkesburg Monday____
Please visit www.caraschool.com for the schedule of
classes offered and times before making your selection
Enclose registration fee of $10 per dancer---family max. $25
(mail to address above)
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Ever received Irish Dance
instruction other than at Cara?___________________________
If “yes” from
whom?__________ for how long? _______
attended last class when?________
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All students
will be required to respect teachers and other students. Inappropriate behavior such as physical
injury to another, defacement of property, or repeated disruption of class may
result in permanent dismissal.
No one is
permitted to dance while wearing a cast.
New and
transfer students may join our class at the beginning of each calendar month
(provided there are openings available).
Transfer students are bound by the rules of the IDTANA and An Coimisiun,
National and International governing bodies of Irish Dance. We reserve the right to decline admission to
transfer students for any reason.
PARENT/GUARDIAN AGREEMENT
I, the parent/guardian
of the registered dancer, a minor, agree that the dancer and I will abide by
the rules of the Cara School of Irish Dance.
Recognizing the possibility of physical injury associated with Irish
dancing and in consideration for the Cara School of Irish Dance accepting the
child for their programs and activities, I hereby release, discharge and/or
otherwise indemnify The Cara School of Irish Dance, their affiliated
organizations and sponsors, board members and associated personnel, including
the owners of dance studios and facilities utilized for the programs, against
any claim by or on behalf of the registrant as a result of the registrant's
participation in the programs and/or being transported to or from the same,
which transportation I hereby authorize. I intend for this consent and agreement
to be legally enforceable.
CONSENT FOR MEDICAL TREATMENT
As the parent/legal
guardian of a participant in The Cara School of Irish Dance, I hereby give my
consent for emergency medical care prescribed by a duly licensed Doctor of
Medicine or Doctor of Dentistry. This care may be given under whatever
conditions are necessary to preserve the life, limb or well-being of my
dependent.
Date:
Signature: