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Libertyville Teen Improv
Please note that summer seasons are a combined 6th Grade-Teens

Beginning and Intermediate
Mid-term registration accepted

Student Name
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Grade (Fall)
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Parent/Guardian Contact 1
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Phone number (cell)
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Phone number (home)
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Phone number (work)
Your answer
Parent/Guardian (Contact 2)
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Phone number (cell)
Your answer
Phone number (home)
Your answer
Phone number (work)
Your answer
Student's Doctor's Name and Number
Your answer
Medical Conditions Staff should be aware of
Your answer
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