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CLASS DAY/TIME MIN CUPPETT PERFORMING ARTS CENTER 135 PARK STREET S.E. VIENNA VA 22180 703-938-9019 CuppettPAC. COM AMY CUPPETT STIVERSON OWNER ARTISTIC DIRECTOR REGISTRATION AND SCHEDULE I the undersigned do hereby agree to the terms and conditions of the Enrollment Agreement and Liability Waiver and Assumption of Risk as stated on the reverse side of this Registration Form. OFFICE Payment Cash/Check Amt PMD Time USE or AP DO or Em or Mailed or Fax or CP or WR SIGNATURE OF PARENT OR GUARDIAN...
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