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Please complete the form Below to reserve your slot in one of our classes. Remember we only take ten students per class, and dates fill quickly.

STUDENT FILE
Student Name:
Address:
City:
Zip:
Phone:
E-Mail:

Preferred Dates:
#1#2#3
Person Completing Form:
Relationship to Student:


Please be sure to indicate three date selections in order of preference (See Schedule). A $100.00 deposit will be required to confirm your registration. We will confirm your date selection by mail.

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