Subject
CHILD'S INFORMATION:
Child's First Name
Child's Last Name
Child's Birth Date
Child's Grade
Name Previous of School
Programs TODDLER (18 MONTHS & OLDER)PRE-SCHOOL (24 MONTHS & OLDER)ELEMENTARY (5 YEARS & OLDER)ENRICHMENTSUMMER CAMP
PARENT/GAURDIAN INFORMATION:
Parent/Guardian Name
Parent/Guardian Address
Parent/Guardian Email
Parent/Guardian Telephone
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MEDICAL INFORMAION:
Physician's Name
Phone Number
Medical Concerns
