emPOWER kids Class Change Request Form 
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Email *
Child's First and Last Name *
Current Class Date

* Request must be made at least 72 hours prior to class time in order to be rescheduled. 
*
MM
/
DD
/
YYYY
Current Class Time 

* Request must be made at least 72 hours prior to class time in order to be rescheduled. 
*
Time
:
Class Type  *
Reason for Change  *
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