Spring Fling Dance Registration

Name: (*)
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Phone Number: (*)
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Address:
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Email: (*)
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List any food allergies:
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Care taker / Emergency contact name:
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Will Caretaker be attending?

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How many will be attending? (*)
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Care taker / emergency contact phone number: (*)
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Send your registration

19920 Bethel Church Road Cornelius, NC  28031 This email address is being protected from spambots. You need JavaScript enabled to view it.  704-892-0546