Ballet Center Utah, Inc. Registration Form

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Ballet Center Utah, Inc. Registration Form

This form is required for your student to begin taking classes at our school. Please fill out the following information.

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* Indicates required question

Email *

Your email

Student First Name *

Your answer

Student Last Name *

Your answer

Student Age *

Your answer

Parent's Name (if student is under 18 years old)

Your answer

Street Address *

Your answer

City, State Zip *

Your answer

Best Contact Number *

Your answer

Is this a: *

Home Phone

Work Phone

Cell Phone

Emergency Contact Name *

Your answer

Emergency Contact Number *

Your answer

Emergency Contact Relation to Student *

Your answer

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