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Registration Form 2024-2025 season
In Step Clogging- Student Information and Registration Form
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* Indicates required question
Student First Name
*
Your answer
Student Last Name
*
Your answer
Student Gender
*
Female
Male
Student Date of Birth
*
MM
/
DD
/
YYYY
Student Current Age
*
Your answer
Parent/Legal Guardian Name
*
Your answer
Billing Address
*
Your answer
Email address
*
Your answer
Cell phone number
*
Your answer
Are you ok with me sending texts to your cell phone?
*
Yes
No
Student cell phone number- if applicable
Your answer
Emergency Contact (other than above)
*
Your answer
Emergency Contact phone number
*
Your answer
Does the student have any allergies we should know about?
Your answer
Does the student take any medications, or have any medical conditions or limitations we should be aware of?
Your answer
Student's pant size (for costumes)
*
Your answer
Student's shirt size
*
Your answer
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