REGISTRATION FORM

Child's Full Name:

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Parent's Full Name:

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Parent's Email Address:

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Address:

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City:

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State:

Massachusetts

Zip Code:

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Home Phone:

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Cell Phone:

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Emergency Contact Name:

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Emergency Contact Number:

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Medical Concerns:

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Location Where Attending Class:

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Town Where Attending Class:

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Class Code:

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Grade:

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Language Registering For:

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Validation Code:

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TERMS AND CONDITIONS: There will be no refunds after the first class. LinguaLinks reserves the right to cancel the class if there are fewer than 8 students. Payment must be received 2 days prior to start of class in order to secure a spot. Information regarding tuition and the start of classes will be displayed once this form is submitted.
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