REGISTRATION

DANCER INFORMATION *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Guardian Name

Required for dancers under the age of 18.

First Name

Last Name

Home Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone Number *

(###)

###

####

KSID Policies *

I have read and agree to all KSID policies.

Tuition Policies *

I agree to keep a valid credit card on file at all times.

I authorize KSID to charge the credit card on file for late tuition payments.

I understand tuition is non-refundable.

KSID Photo Release *

I grant permission for the dancer(s) named on this form to be included in photographs and/or videos of activities with The Kelly School of Irish Dance. I understand that images may appear in KSID social media, websites, publications, KSID advertisements, and printed materials. I understand that I am not eligible for compensation for or ownership rights to photos used by KSID.

I have read the above and agree.

I have read the above and do not agree.

Release of Liability *

I/we understand that participation in dance classes and activities could potentially involve some personal injury. Despite precautions, accidents and injuries may occur. Through signing this release form, I/we (the dancer(s) and parent/guardians) assume all risks related to the use of any and all spaces used by The Kelly School of Irish Dance, LLC, (KSID). I/we agree to release and hold harmless KSID, including its owners, teachers, dancers, staff members, and facilities used by both entities from any cause of action, claims, or demands now and in the future. I/we will not hold KSID liable for any personal injury or any personal property damage or loss, which may occur on the premises before, during, or after classes. Furthermore, I/we agree to obey the class and facility rules and take full responsibility for my/our behavior in addition to any damage I/we may cause to the facilities utilized by KSID.

I have read the above liability release and agree. I fully understand its terms.

I do not agree. My self / dancer forfeits registration.

WAIVER/RELEASE FOR COMMUNICABLE DISEASES INCLUDING COVID-19 *

In consideration of being allowed to participate on behalf of The Kelly School of Irish Dance, Irish Dance program and related events and activities, the undersigned acknowledges, appreciates, and agrees that:
 1. Participation includes possible exposure to and illness from infectious diseases including but not limited to MRSA, influenza, and COVID-19. While rules and personal discipline may reduce this risk, the risk of serious illness and death does exist; and,
 2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and,
 3. I willingly agree to comply with the stated and customary terms and conditions for participation as regards protection against infectious diseases. If, however, I observe and any unusual or significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately; and,
 4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS The Kelly School of Irish Dance, their teachers, officials, agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event with respect to any and ALL ILLNESS, disability, death, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF RELEASEES OR OTHERWISE, to the fullest extent permitted by law.


I have read the above release for communicable diseases and agree. I fully understand its terms..

I do not agree. My self / dancer forfeits registration.

Date Signed *

MM

DD

YYYY

Select payment method *

Invoiced + Automatic tuition payments are subject to a 4% convenience fee.

Cash or Check

KSID Website

Venmo @kellyirishdance

Automatic Payments

Scheduled Invoice