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* 1. What is your name?

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* 2. What is your child's name?

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* 3. What is your phone number?

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* 4. Which class would you be interested in signing up for?

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* 5. How old is your student?

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* 6. Which school does your student attend (if any)?

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* 7. What is your student's birthday?

Date

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* 8. Does your student have any experience with music?

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* 9. What is your student's favorite way to experience music? Radio? Movies? Live performance?

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* 10. Are you ready to register your child for this Carrendo music class now?

T