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2022 - 2023 Company Auditions (6-9 years)

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	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)*

Students entered below will be added to your family's account

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	Student's First Name: *	Last Name: *
	Student Gender: *	Birth Date: * (format=mm/dd/yyyy)
	Student Email:
	School:*	Grade Level:*
	Disabilities (Leave blank if NONE):
	Allergies (Leave blank if NONE):
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	Primary Doctor:
	Do you have a fever?:*
	Cough, Shortness of Breath?:*
	Exposed to anyone w/ Covid 19?:*
	Sore throat, headache, chills?:*
	Loss of Taste or Smell?:*

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Questions/Options:


Where have you studied dance?*
How long have you studied each genre: Ballet, Jazz, Contemporary, Hip Hop, Tap?*

Additional Information:

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