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Dancers Information

[field id="FirstName"] [field id="LastName"]
[field id="DOB"] Age [field id="Age"] Grade [field id="GradeLevel"]
Medical Conditions [field id="MedicalInfo"]


Parent/Guardian Information

[field id="ParentName"] [field id="ParentLast"]
[field id="ParentEmail"]
Home Phone: [field id="ParentHomePhone"]
Cell Phone: [field id="ParentCellPhone"]
Work Phone: [field id="ParentWorkPhone"]
Address: [field id="Address"] [field id="AddressLine2"]
City:[field id="City"], State [field id="State"] Zip: [field id="ZipCode"]


Emergency Contacts

[field id="EC1"] [field id="EC1Last"]
Phone: [field id="EC1Phone"] , Cell: [field id="EC1Cell"]
[field id="EC2Name"] [field id="EC2Last"]
Phone: [field id="EC2Phone"], Cell: [field id="EC2Cell"]


Tuition

[field id="Tuition"]
Classes: [field id="ClassOptions"], Registration Fee: [field id="RegFee"]


Referred By: [field id="Referral"]
Terms: [field id="Terms"]


Parent/Guardian signature [field id="Sign"]
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