Professional Documents
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(510) 232-5650
Parents First & Last
Name
Age of
Child/ren
Please select your 1st, 2nd, 3rd choice next to each class listed. Space is limited;
every effort will be made to accommodate one of your three choices.
Is this your first class with us? Yes_____ No______
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Date of
Birth
Home Address
Drop In Classes
3/5/14