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The Dance Centre - August Summer Classes Registration
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* Indicates required question
Dancer's Name
*
Your answer
Birthdate
*
MM
/
DD
/
YYYY
Parent/Guardian's Name(s)
*
Your answer
Email Address
*
Your answer
Phone Number
*
Your answer
Additional Phone Number
*
Your answer
Address
*
Your answer
Medical Information
*
Your answer
Emergency Contact Name
*
Your answer
Emergency Contact Phone Number
*
Your answer
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