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Registration Form

NAME OF STUDENT

BIRTH DATE

NAME(S) OF PARENT(S)/GUARDIAN(S)

E-MAIL

PHONE

ADDRESS

TERM

PROGRAM

HOW MANY CLASSES PER WEEK?

Type of Lesson

PREFERRED CLASS

#2 PREFERRED CLASS (in case your first choice is not available)

How you heard about us? (Please check one)


Please Contact us Regarding Tuition

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