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Child's First Name
   
 
 
 
Child's Last Name
   
 
 
 
Gender
 
Boy
 
Girl
 
 
 
Child's date of birth
 
 
 
Age
   
 
 
 
Entering Grade
   
 
 
 
Musical & Theatre Experience (school/church/etc.)
   
 
 
 
Parent/Guardian Name
   
 
 
 
Home Address
   
 
 
 
City, State, Zip Code
   
 
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