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An Daire Academy Class Enrollment
Class Registration & Student Information Form
Email address
Student Last name, First Name
Your answer
Student Date of Birth
Parents Name(s) - First & Last
Your answer
Your answer
Phone #
Your answer
Mailing Address (Street, City, State, Zip)
Your answer
Known Allergies / Health Conditions:
Your answer
Emergency Contact Info:
Your answer
Phone # (Emergency Contact)
Your answer
1st Class Option
2nd Class Option
3rd Class Option
4th Class Option
Registration Fee
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