To register for classes, please fill out the following medical form.
Please note: Personal information is only used for contact or emergency purposes. Your information will not be sold to or given to anyone other than Kaethe Birkner or a representative of Kaethe, including a substitute instructor, which would only happen in event of an situation or emergency which prevents her from contacting you herself.
By applying my digital signature below, I hereby declare the information above to be accurate and complete. Sign and submit to continue to the next form.
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