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*
Parent/ Guardian First name:
*
Parent/Guardian Last name:
*
Parent/Guardian Mobile Phone:
*
Parent/Guardian Email:
Occupation:
Parent/Guardian Work Phone:
*
Address
Parent/Guardian First Name:
Parent/Guardian Last Name:
Parent/Guardian Mobile Phone:
Email
Occupation
Parent/Guardian Work Phone:
*
Dancer's First Name:
*
Dancer's Last Name:
*
Dancer's Birthday
Month
Month
Day
Year
*
Dancer's Age
*
Dancer's T-Shirt Size
Emergency Contact Information
*
Primary Emergency Contact Name:
*
Relationship to Child
*
Cell Phone Number:
Secondary Emergency Contact Name:
Relationship to Child
Cell Phone Number:
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