Registration

JAZZ TEAM ENTERTAINERS!!

Event:

Start Date/Time:

End Date/Time:

Fee per Student:

Room:

* - denotes required fields

FAMILY INFORMATION

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

	Address: *
	City: *	State: * Zip: *

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

Add New Student #1:

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Additional Information: