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Class Request
Future dance programs (Summer 2024 & Season 2024/2025)
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Email
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STUDENT LAST NAME
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STUDENT FIRST NAME
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STUDENT Date of Birth
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MM
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YYYY
STUDENT Age
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Phone #
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xxx-xxx-xxxx
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STUDENT Medical Information
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Please list any allergies or existing medical conditions.
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Parent Name: First, Last
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Address
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