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Leap Dance Midlands
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Name of Adult/Parent
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Email address
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Child's full name
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Child's age and Date of Birth
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Class/es interested in joining
Toddler and Grown Up
Primary (3 and over)
Junior (aged 6 and over)
Ballet Be Fit adult Beginner
Ballet Be Fit Improver (some fitness or dance experience)
Adult Pure Ballet class
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Mobile/ emergency contact number
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