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2023/2024 Blackthorn Academy Registration and Class Enrollment Form
Student Contact Information Form
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E-Mail-Adresse
*
Ihre E-Mail-Adresse
Student First Name & Last Name
*
Meine Antwort
Dancer's pronouns. Please share the pronouns the dancer wishes to use. Pronouns are the part of speech used to refer to someone in the third person. We want to know how to respectfully refer to each dancer!
Meine Antwort
Student Date of Birth
*
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MM
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JJJJ
Parents Name(s) (if participant is a minor) - First and Last
Meine Antwort
Parent's pronouns. Please share the pronouns the parent(s) wish to use.
Meine Antwort
Email Address:
*
Meine Antwort
Contact Phone Number
*
Meine Antwort
Mailing Address (House # / Street, City, State, Zip)
*
Meine Antwort
Known Allergies / Health Conditions:
Meine Antwort
Emergency Contact Info:
*
Meine Antwort
Phone Number (Emergency Contact)
*
Meine Antwort
How did you hear about us?
Website
Flyer at a performance
Tear-Off Flyer / Community Board
Other Dance Site Listing
Referral from an Blackthorn family or friend
Instagram
Facebook
Other
Auswahl löschen
Mondays - EUGENE / Denfinity Dance Studio
Beginner Irish Dance 4pm-4:50pm (Ages 5+)
Advanced Irish Dance 5pm-5:50pm (Ages 8+)
Adult/Championship 6pm-7pm (Ages 13+)
Wednesdays - EUGENE / Upstart Crow Dance Studio
Beginner Irish Dance 5:30pm-6:20pm (Ages 5+)
Beginner Hard Shoe Irish Dance 6:30pm-7:20pm (Ages 8+)
Adult/Championship 7:30pm-9pm (Ages 13+)
Do you have interest in taking more than one class per week? Any interest in hard shoe classes?
Meine Antwort
Annual Registration Fee
*
Individual ($75) - one student
Family ($100) - 2 or more dancers from the same immediate family (not extended or related, ie. cousins)
Pflichtfrage
Monthly Tuition
90 min. Adult/Championship Classes - $150/month
50 min. - Beginner/Advanced Classes - $100/month
60 min. - Adult/Championship Classes - $120/month
Two Adult/Championship Classes per week - $210/month
Two Beginner/Advanced Classes per week - $150/month
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