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| 2008/09 FALL ENROLLMENT REGISTRATION FORM Name:_____________________________________ Age:_____________________________ Address:_______________________________________________________________________ City/State/Zip:___________________________________________________________________ Home phone:_________________________ Work phone:_____________________________ E.mail:_______________________________ Cell Phone:______________________________ Person responsible for payments:_____________________________________________________ If student is a minor, Guardian’s Name:________________________________________________ Is there a weakness we should be aware of?____________________________________________ List previous training if any:_________________________________________________________ Why did you choose Flint’s?________________________________________________________ Class/Level/Dates____________________________ $30 deposit________________________ Class/Level/Dates____________________________ $30 deposit________________________ Class/Level/Dates____________________________ $30 deposit________________________ Class/Level/Dates____________________________ $30 deposit________________________
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