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Mommy & Me 2014.jpg

mmmy and me.jpg


Mommy and Me Registration Form

First Name



Last Name



Name of Child

      Age of Child  
Attending:  Fall Session  Winter Session  Spring Session
Payment - $5/class, 15% discount will be applied to all prepaid sessions.
CC Type   Card Number
Billing Address   City, State, Zip   
Charge Amount   Exp Date