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Register Now!
Register now for the Kids Remix Summer Fix. The Registration Fee is $25.
Child's Name
*
First
Last
Child's Age
*
Child's Birthdate
*
Date Format: MM slash DD slash YYYY
Child's Grade
Parent/Guardian's Name
*
First
Last
Address
*
Street Address
City
State / Province / Region
ZIP / Postal Code
Parent/Guardian's Contact Number
*
Alternate Contact Number
Parent/Guardian's Email
Allergies (please list for each child)
Signature
*
Sign the form using your mouse or using a stylus or finger if signing on mobile device
Registration Fee (covers all children living in the household)
*
Price:
$25.00
Quantity:
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$0.00
Date
Date Format: MM slash DD slash YYYY
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