Winter Dance Clinic
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Email address *
Athelete's Name *
Your answer
Parents Name(s) *
Your answer
Primary Phone *
Your answer
I am willing to receive text messages on the "Primary Phone" *
Primary E-mail: *
Your answer
Address: *
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Emergency Contact & Phone: *
Your answer
Athlete T-shirt size? (Please state youth or adult as well as size) *
Your answer
A copy of your responses will be emailed to the address you provided.
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