Kelli's Kreative Dance Online Registration

Registration

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Welcome to Kelli's Kreative Dance! Unfortunately, registration for the current dance year is now closed. Please refer to our website at KellisKreativeDance.com for our sign up to receive information regarding our next available registration which will be Summer 2023.

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Referral Information

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Referral Name

Family Information

Family Last Name*

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Home Address*

City*

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Zip*

Home or Primary Phone*

Additional Info

Emergency Contact Info (Not Contact #1 or #2)

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Contact #1

Contact #1 First Name*

Last Name *

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Work #

Cell # *

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Confirm Email*

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Contact #2

Contact #2 First Name

Last Name

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Student #1

Student's First Name*

Last Name*

Student Gender*

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Additional Info

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Student #2 (Show-Hide Details)

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Student #3 (Show-Hide Details)

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Student #4 (Show-Hide Details)

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Student #5 (Show-Hide Details)

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Exp Year *

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Address Line 1

Address Line 2

City

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Zip*

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Registration

Referral Information

Family Information

Where do you live?

Additional Info

Contact #1

How Can We Contact You?

Portal Access (your email is your login)

Contact #2

How can we contact you?

Student #1

Additional Info

Student #2 (Show-Hide Details)

Additional Info

Student #3 (Show-Hide Details)

Additional Info

Student #4 (Show-Hide Details)

Additional Info

Student #5 (Show-Hide Details)

Additional Info

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