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