Saturdays in the Studio Registration | Department of Dance

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Guardian First Name

Guardian Last Name

Child First Name

Child Last Name

Optional: Child Nickname

Child Age

Child Grade Level

Child Dietary Restrictions

Child Allergies or Health Risks

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

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Phone Number

Optional: Secondary Phone Number

Email

Emergency Contact Name

Emergency Contact Phone Number

Previous Dance Experiences