MacConmara Academy Online Registration

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Welcome to MacConmara Academy of Irish Dance!

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Referral Information

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Family Information

Family Last Name*

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Home Address*

City*

State*

Zip*

Home or Primary Phone*

Contact #1

Contact #1 First Name*

Last Name *

Type

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Cell # *

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Confirm Email*

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Confirm Portal Account Password

Contact #2

Contact #2 First Name

Last Name

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Confirm Email

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Cell #

Additional Info

Student Email

T-Shirt Size

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Please arrive 10 before each class. Bring a water bottle with you. Wear comfortable clothing (ie: shorts, t-shirt,) and bring shoes and socks. Please make sure your hair is pulled back.

Enroll in Classes

Select Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Cell #

Additional Info

Student Email

T-Shirt Size

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Please arrive 10 before each class. Bring a water bottle with you. Wear comfortable clothing (ie: shorts, t-shirt,) and bring shoes and socks. Please make sure your hair is pulled back.

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Cell #

Additional Info

Student Email

T-Shirt Size

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Please arrive 10 before each class. Bring a water bottle with you. Wear comfortable clothing (ie: shorts, t-shirt,) and bring shoes and socks. Please make sure your hair is pulled back.

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Cell #

Additional Info

Student Email

T-Shirt Size

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Please arrive 10 before each class. Bring a water bottle with you. Wear comfortable clothing (ie: shorts, t-shirt,) and bring shoes and socks. Please make sure your hair is pulled back.

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Cell #

Additional Info

Student Email

T-Shirt Size

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Please arrive 10 before each class. Bring a water bottle with you. Wear comfortable clothing (ie: shorts, t-shirt,) and bring shoes and socks. Please make sure your hair is pulled back.

Enroll in Classes

Select Class

Add Another Student

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Referral Information

Family Information

Where do you live?

Contact #1

How Can We Contact You?

Portal Access (your email is your login)

Contact #2

How can we contact you?

Student #1

Additional Info

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Student #2 (Show-Hide Details)

Additional Info

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Student #3 (Show-Hide Details)

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Required Policies

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