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Island Dance Academy
Registration 2024-25
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Account/Parent Name:
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Student Name:
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Student Birthdate:
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YYYY
Student Age:
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Student Grade:
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Street Address:
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City:
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Zip Code
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Phone Number:
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Email Address:
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Emergency Contact Name & Relationship:
(SOMEONE OTHER THAN YOU)
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Emergency Contact Phone Number
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Anything we should know about your child?
(Allergies, Medical Conditions, Special Accommodations, etc)
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Previous Dance Experience?
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Classes you would like to register for:
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