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Allergies and health information form
Please fill out the following form for each of your dancers before registering
First name of Dancer
*
Last name of dancer
*
Email
*
This dancers date of birth
*
Year
Month
Month
Day
Does this dancer have any allergies?
*
No
Yes
Are there any medical conditions that we should know about this dancer?
*
No
Yes
If you answered yes to any of the questions above, please supply additional information.
Signature
*
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