Wichita Children's Theatre & Dance Center Online Registration

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Wichita Children's Theatre & Dance Center Registration

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Referral Information

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Family Last Name*

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Additional Info

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Contact #1

Contact #1 First Name*

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Type*

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Contact #2

Contact #2 First Name

Last Name

Type

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Work #

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Confirm Email

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Student Email

T-Shirt Size

School

Grade Level*

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

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Medications (Leave blank if NONE)

Primary Doctor

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Student Gender*

Birth Date*

Additional Info

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Primary Doctor

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Student #3 (Show-Hide Details)

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Medications (Leave blank if NONE)

Primary Doctor

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Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

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T-Shirt Size

School

Grade Level*

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

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Registration

Referral Information

Family Information

Where do you live?

Additional Info

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

Enroll in Classes

Student #2 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #3 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #4 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #5 (Show-Hide Details)

Additional Info

Enroll in Classes

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Required Policies

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