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| REGISTRATION (Pre-registration is required) |
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Student Name:
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Date of Birth:
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Parent/s Name:
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Address:
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Phone:
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E-mail:
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Emergency Contact:
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Emergency Phone:
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Allergies:
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Program:
| Please include the Program you are registering for, the Day, Location & Time. |
| Mail Registrations to: PO Box 806 Glen Cove, NY 11542 Contact Miss Kathleen with any questions. kathleen@ryanacademy.com |
