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Name: __________________________________
Date of Birth: ______________ Age: ______
Other Info: ______________________________ |
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Address: ___________________________________ City: _______________ State:
_____ Zip: _________
Phone #: _____________ Email Address: ______________________
_____ Kinder-Dance
_____ Tap
_____ Ballet
_____ Lyrical
_____ Jazz
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_____ Adult
Dance Class
_____ Technique
_____ Triple Threat (Musical Theater)
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PARENT: _____________________________ CHILD'S NAME:
___________________
DATE: __________ |
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