Rhythm Works Class
Please fill out the following form for our 10 week class for students ages 5-12. The class will meet at the Encore Center at 160 E New Hampshire, Southern Pines, NC on Mondays at 3:45 for 30 minutes.
Student Name (First and Last) *
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Parent or Caregiver Names *
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Birthdate *
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Contact E-mail *
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Contact Phone Number *
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Address *
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Special Needs (be specific for our planning purposes please) *
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