Five Flags Dance Academy, LLC Online Registration

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Thank you for registering with Five Flags Dance Academy. Ms. Ashley & Mr. Chris

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Additional Info

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Contact #1

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Student #1

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Grade Level*

Transportation

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Student #2 (Show-Hide Details)

Student's First Name*

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Birth Date*

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Student Email

T-Shirt Size

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Student's First Name*

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T-Shirt Size

School*

Grade Level*

Transportation

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

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Primary Doctor

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Referral Information

Family Information

Where do you live?

Additional Info

Contact #1

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Who is your employer?

Student #1

Additional Info

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Student #2 (Show-Hide Details)

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