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St Pius- X

Pre- K Dance

First name*

Last name*

Student Name:*

Student Age:*

Student's Teacher:*

Guardian Email*

Guardian Phone*

Cost: $75 / Venmo @niki-reed*

Paid by venmo @niki-reed

www.kennedymovement.com

info@kennedymovement.com

Latham, NY 12110

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