Ceili Irish Music & Dance Camp On-line Registration Form

Ceili 2009 On-line Registration is a 2 Step Process:

Email	*required
Registrant's Name
Phone
Mailing Address
Birth date (minors)
Parents’ Names (if registrant is a minor)
Personal Health Number
Health Concerns/Allergies
Course Registration:
Homeroom Choice (3 hour class)	*please include level
Elective 1 Choice (1 hour class)	*please include level
Elective 2 Choice (1 hour class)	*please include level
Registrant is an unaccompanied minor requiring accommodations, meals, and den mother supervision	Yes No
Complementary T-Shirt Size
Fill in this section if a family member is signing up for the Afternoon Elective only.
Elective ONLY Choice	*please include level
Name of family member taking elective
Complementary T-Shirt Size
Optional: Additional T-Shirts $20. Indicate Size