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kids registration
Child's Name
*
Child's Last Name
*
Birthday
*
Month
Month
Day
Year
Grade Completed
*
Parent/Guardian
*
Address
*
Phone
*
Email
Who can pick up your child?
*
Gender
*
Male
Female
Food Allergies
*
No
Yes
If "YES", what are they?
Medical Conditions?
*
Emergency Contact and Phone Number
*
Relationship to Child
*
Submit
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