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Registration Form
Name _________________________________
Address________________________________ Parent’s Name___________________________ Home Phone ________________ Work Phone ________________ Emergency Phone____________ Session Desired______________ Child’s Age_________________ Birth date___________________ How long has your child played the piano/keyboard? ___________________________ Has your child taken musical instruction other than piano or keyboard? ___________________________ Food Allergies _________________________________________ Print out form, complete, and send to:
Contemporary Keyboard Studios 6051-C Arlington Blvd. Falls Church, VA 22044
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Last modified: 03/17/08 |
