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2. Class Registration Information
4. Last Name*
5. First Name*
6. Middle Initial*
8. Address*
9. Apartment/Unit #
11. City*
12. State*
13. Zip Code*
15. Phone Number*
16. Alternate Phone
18. Birth Date*
20. Other Info
22. Court Date
23. Case Number
25. Class Name
26. Class Date
28. Rescheduled
30. Additional Info
32. REMINDER:
34. MONEY ORDER
35. DRIVER'S LICENSE (or photo id)
36. ARRIVE 15 MINUTES PRIOR
38. We do NOT accept cash.
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40. 1. Receive an email copy of this form.
41. Email address

    This field is not part of the form submission.

42. Submit

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