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C4 2019 - 2020 Registration Form
C4 Performing Arts, LLC Registration Form for 2019 - 2020.
Email address *
Student's First Name *
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Student's Last Name *
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Parent's First Name *
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Parent's Last Name *
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Mailing Address *
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City *
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Zip Code *
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Home Phone *
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Cell Phone *
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Gender *
Age *
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Birth Date *
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YYYY
Grade *
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Current School *
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Allergies/ Medication *
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Emergency Contact and Relationship *
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Emergency Contact Address (Address, City, and Zip Code) *
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Emergency Contact Phone Number *
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Emergency Contact Email *
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