NMSDT Prep Clinic Registration
Please fill out a seperate registration form for each dancer attending
Friday- May 3, 2019 4pm -6pm
Meads Mill Gym
Hosted By: Northville Varsity Competitive Dance Team
Participant Name: *
Your answer
Participant Age *
Your answer
Participant Grade (2019-2020)
Your answer
Participant School (2019-2020)
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Parent Name:
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Parent Phone Number:
Your answer
Home Address:
Your answer
Parent Email: *
Your answer
Emergency Contact: Name & Phone Number
Your answer
Insurance Carrier & Policy Number:
Your answer
Participant Allergies: *
Your answer
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