Pre-registration Form

UptownDans@aol.com


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247 Blue Hill Avenue
Roxbury, MA 02119
617-445-4444
Leta Tavares, Director
Registration fee includes: Payment for one costume, production fees, insurance and administrative fees.

Registration may be made by mail or in person at the studio.
Registration fee: $125.00
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Student Information
          
                     Student 1     Student 2  Student 3
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Has student had any prior dance training?
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Does child have any pre-existing medical problems?
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