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Child's First Name: *
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Child's Last Name: *
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Child's Date of Birth: *
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Parents' Name: *
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Email: *
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Address: *
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Phone Number: *
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Name of Parent or Caregiver Attending: *
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Medical Information (Allergies or Medical Conditions): *
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I would like my children to attend class on the following days: *
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All fees are due by April 22, 2019
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