Registration
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Join us for our annual summer dance camps! Open to anyone ages 3-8, the mornings will be filled with magical dancing, crafting, games and fun! Space is limited, and pre-registration is required!
Event:
Start Date/Time:
End Date/Time:
Fee per Student:
Room:
*
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Family Information
First Name:
*
Last Name:
*
Type
Caregiver
Father
Guardian
Mother
Parent
Self
Home Phone:
Cell #:
Work #:
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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Emergency Contact Info (Not Contact #1 or #2)
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Students entered below will be added to your family's account
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Student's First Name:
*
Last Name:
*
Birth Date:
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Student Email:
Disabilities (Leave blank if NONE):
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
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Student's First Name:
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Birth Date:
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Student Email:
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Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
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Student's First Name:
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Last Name:
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Birth Date:
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Student Email:
Disabilities (Leave blank if NONE):
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
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Student's First Name:
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Last Name:
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Birth Date:
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Student Email:
Disabilities (Leave blank if NONE):
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Add New Student #5:
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Student's First Name:
*
Last Name:
*
Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
Disabilities (Leave blank if NONE):
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Additional Information:
Other Questions/Comments:
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Exp Year:
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Address Line 1:
Address Line 2:
City:
State:
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GA
HI
IA
ID
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KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
PR
VI
Zip:
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