Parent Child Registration

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Parent Child Registration

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* Indicates required question

Parent(s)/Guardian(s) Names (please list both parents/guardians if applicable) *

Your answer

Name of person who will attend class with child: (room size only permits one adult attending with one child) *

Your answer

Address: *

Your answer

City: *

Your answer

Zip Code: *

Your answer

Email Address: (first parent/guardian) *

Your answer

Email Address: (second parent/guardian)

Your answer

Phone Number: (first parent/guardian) *

Your answer

Phone Number: (second parent/guardian)

Your answer

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