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Get the free 00 October 26, November 2, 9, 16, 23, 30 (Weekly Lesson include 30 min

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Male Name: Date of Birth: OR Female (please circle) Age: Address: City: State: Home Phone: Zip: Cell Phone: Parent / Guardian Name: Parent/Guardian Signature: Current Email: WAIVER Signature: I, the
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Begin by entering the date, starting with the month (October) followed by the day (26th) and then the year (November). Double-check the accuracy of the dates before proceeding.
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