Student's Name
Date of Birth
Parent's Name
Address
City
Zip Code
Phone Number
E-mail
Years of Dance
Registration Form:
Address
:
1678 St. Patricks Blvd.
Ponchatoula, LA 70454
Phone
:
(985) 386-5356
Contact Information:
Website
:
www.steppinoutdancing.com
E-mail Addresses
:
April- brickwoman22@g
mail
.com
Cathy- dagomom50@yahoo.com
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&
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