Registration

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Join us for FREE online dance classes for the next 2 weeks until March 30th 2020. We will have a wide variety of classes available in all levels & styles. We will be emailing those that are registered the online virtual class video links & more fun things to do while at home!

Event:

Start Date/Time:

End Date/Time:

Fee per Family:

Room:

* - denotes required fields

Family Information

	First Name:*	Last Name: *
	Type*
	Home Phone:*	Cell #: Work #:
	Email:*	(Emails are kept confidential)

	Address: *
	City: *	State: * Zip: *
	Emergency Contact Info (Not Contact #1 or #2)

Add New Student #1:

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	Student's First Name: *	Last Name: *
	Student Gender: *	Birth Date: * (format=mm/dd/yyyy)
	Grade Level:*
	Disabilities (Leave blank if NONE):
	Allergies (Leave blank if NONE):
	Medications (Leave blank if NONE):

Questions/Options:


How old is your child (or children)
What type of virtual class are you interested in?
Any other comments?

Additional Information:

Liability Release

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I've read the above and agree.

Enter your Full Name: