Course Registration Form

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SING ACT DANCE

May 4- June 22nd

1
Student Name* This field is required.
First Name
Middle Name
Last Name
2
Birth Date
Month
Day
Year
3
Parent E-mail* This field is required.
example@example.com
4
Mobile Number* This field is required.
5
Additional Comments
6
Please Select a Class * This field is required.
Please Select
Please Select
Ages 3- 8 Thursdays 4:15-5:00 PM
Ages 9-13 Thursdays 6:30-7:15 PM
Should be Empty:

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