1
Step 1
Parent Full Name
your full name
Email Address
a valid email
email
Tel
your phone number
Additional Tel
your phone number
Allergies or Special Needs?
more details
0
/
250
Number of Children
One Child
Two Children
Three Children
Four Children
Child 1 Name
1name
no-icon
Child 1 Age
Child 1 Age
4
5
6
7
8
9
10
11
12
13
14
15
Child 2 Name
1name
no-icon
Child 2 Age
Child 2 Age
4
5
6
7
8
9
10
11
12
13
14
15
Child 3 Name
1name
no-icon
Child 3 Age
Child 3 Age
4
5
6
7
8
9
10
11
12
13
14
15
Child 4 Name
1name
no-icon
Child 4 Age
Child 4 Age
4
5
6
7
8
9
10
11
12
13
14
15
Would you like to be added to the Leslieville School of Dance mailing list?
Yes
No
SUBMIT
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