KC DANCEWORKS
Pre-registration form
Email address *
Student name *
Your answer
Student birth date *
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DD
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YYYY
Parent name *
Your answer
Parent phone *
Your answer
Parent e-mail address *
Your answer
Street address *
Your answer
City *
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State *
Your answer
Zip code *
Your answer
Emergency contact name *
Your answer
Emergency contact phone number *
Your answer
Class interest (check all that apply) *
Required
Tell us what you'd like for you or your child to learn from dance.
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How did you hear about us?
A copy of your responses will be emailed to the address you provided.
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