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Fill the following form to get registered for Freshman Twice a Week classes
First Name
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Last Name
Gender
*
Boy
Girl
Date of Birth
*
School
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Home Address
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City
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State
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Utah
Utah
Zip Code
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Parent or Guardian First Name
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Parent or Guardian Last Name
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Primary Phone
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Email
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Emergency Contact Name and Phone Number. Please list any Medical Restrictions and/or allergies to Medicine.
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Payment Details
Freshman Age 7 - 8 4:00 PM - 5:00PM (Tuesdays and Thursdays)
*
Total
$
90
Credit/Debit Card
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