SECTION 2 - Student Information |
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| Student’s First Name* |
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| Student’s Last Name* |
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| Student’s birthdate* |
(is adult) |
| Student’s school and grade |
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| Current Lesson/Class |
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| Current Instructor |
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| Current lesson day and time |
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| Checkbox to keep current schedule |
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Please indicate any changes or additions in the following text box:
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| Please check here only if you do not grant permission to use my/my child's image in promotional materials.
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