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YOGA, MOVEMENT, & MUSIC
KACP Program
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Email
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Child's Name
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Child's Age:
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Parent's Name:
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Option 1
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Address
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Phone number
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Additional Comments to share about your child:
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By typing my name below, I accept and understand the information, and liability.
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I give permission for my child to participate and release Cynthia Bernard of any and all liabilities, risks or injuries that may occur as a result of participating in this program.
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