Fillable WPMPA Summer Intensive Rego form 2014

! SUMMER DANCE INTENSIVE Registration Form Jan 1923, 2015 ! ! Full Student Name D.O.B. Address Email (Please PRINT clearly) Alternative email Phone EMERGENCY CONTACTS Emergency contact name Relation to Student. (eg; mother) Emergency during the day Ph Allergies/previous, reoccurring, current injuries including treatment that may affect your participation in these classes I hereby waiver all claims of injury,...
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