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Parents, make plans for a Valentine's date night while the kids are having a blast with us! We'll craft, dance, play, and enjoy a pizza dinner. No previous dance experience required, so bring a friend.
Event:
Start Date/Time:
End Date/Time:
Fee per Student:
Room:
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Family Information
First Name:
*
Last Name:
*
Type
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Parent
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Email:
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Address:
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City:
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State:
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Zip:
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Students entered below will be added to your family's account
Add New Student #1:
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Student's First Name:
*
Last Name:
*
Student Gender:
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Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Add New Student #2:
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Student's First Name:
*
Last Name:
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Student Gender:
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Birth Date:
*
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Student Email:
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Add New Student #3:
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Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Prefer Not to Say
Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Add New Student #4:
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Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Prefer Not to Say
Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Add New Student #5:
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Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Prefer Not to Say
Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Additional Information:
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