Fall 2018 Registration
Dancer's Full Name *
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Street Address *
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Town *
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Class Days and Times *
Required
Birth Date *
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DD
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Phone # *
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Emergency # *
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Email Address *
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Parent's Full Name *
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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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