Winter Show 2019 Ensemble Registration Form

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Winter Show 2019 Ensemble Registration Form

Groove Force Productions presents a Winter Show 2019

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* Indicates required question

Email *

Your email

First Name *

Your answer

Last Name *

Your answer

Phone Number *

Your answer

Address *

Your answer

City *

Your answer

Postal Code *

Your answer

Date of Birth *

MM

/

DD

/

YYYY

Age *

Your answer

Dancer is under 19 years of age *

Yes

No

Emergency Contact Name & Phone # *

Your answer

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