Aerial Dance Summer Camp 2023
Registration  Form
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Email *
Name of Student *
Age *
Date of birth
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/
DD
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YYYY
Which dates would you like to attend *
Address
Street, City and City Code
*
Parent 1 (required) *
Email *
Home phone and cell phone *
Parent 2 (optional) *
Email *
Cell phone *
Emergency contact name and phone no. *
Allergies or anything important to know
A copy of your responses will be emailed to the address you provided.
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