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Personal Information Update Form

Please use this form to update any change in personal information such as address, email address, phone number, etc.

Student Last Name

Student First Name

Street Address

City

State

Zip

Student Date of Birth

Primary Email (this will be used to send PHCB notifications)

Phone #1

Phone #2

Emergency Phone

Class (hold ctrl-key & click all that apply)

Person(s) Responsible for Payment

Additional information for PHCB

By clicking "submit" you are confirming that you understand and agree to adhere to the PHCB Studio policies as stated on this website and available in writing at the PHCB studios, upon request. Privacy: PHCB will not share this information with 3rd parties and will utilize it only to conduct PHCB related business. Information should be updated annually or whenever changes occur for insurance/liability purposes and to update emergency contact information.

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Personal Information Update Form