Class Registration Summer 2017
First Name of Participant
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Last Name of Participant
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Guardian Name (if minor)
Your answer
Primary Phone Number
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Alternative Phone Number
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Birth date
Must be at least six years of age
MM
/
DD
/
YYYY
Email Address
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Street Address
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City
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Zip Code
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Emergency Contact Name Concerning minors: if there is an emergency, guardian will be contacted first, please provide an alternative in the event guardian is unreachable
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Relationship to student
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Emergency Contact Phone Number
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How did you hear about Jubilee Arts? Please select all that apply
Which class(es) are you registering for?
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