Enrollment Form____________________________________________________________
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Parent/ Guardian Name
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Student Name
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Date of Birth
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Address
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Phone#
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Email
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Emergency Contact
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Any Medical Conditions, Allergies, Injuries that we should be aware of?
Classes:
___Ballet
___Jazz
___Acrobatics
___Hip Hop
___Pointe
___Tap
___Contemporary
___Musical Theater
___Clogging
___Combination(4-6 yrs)
$40 Academy Enrollment Fee – ( Due at Registration. Non Refundable)
Signature _______________________________________________________________Date________________________________