Fall 2020 Registration
Dancer's Full Name *
Street Address *
Town *
Fall Class Days & Times *
Required
Birth Date *
MM
/
DD
/
YYYY
Phone # *
Emergency # *
Email Address *
Parent's Full Name *
Parent's E-Signature *
I understand that Dance By Leslie is not responsible for any injuries or any kind sustained by me or my child, and I cannot hold the studio responsible for loss or destruction of personal property owned by me.
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