Kids Taiko Registration Form — South Bay Beat Institute

Name of Person Completing this form

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Name of child you're registering (one child per form)

First Name

Last Name

Your relationship to the child (i.e., parent, grandparent)

Child's date of birth

YYYY

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