Matilda jr. Registration Form
Student Contact Information
Name *
Contact Email *
Student Phone Number
Student Date of Birth *
Medical Information
Student's medical requirements (medication/allergies/special needs)
Parent/Guardian Contact Information
Name *
Parent/Guardian Name
Parent Contact Email *
Parent/Guardian Phone Number *
Alternate Parent/Guardian Contact Information
Name
Contact Email
Alternate Guardian Phone Number
DYT Company Commitment Policy Information
I have read and agree to commit
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