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Afterschool Registration form
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* Indicates required question
Name of the Child
*
Your answer
Grade
*
Your answer
Mother's Name
*
Your answer
Mother's Email Address
*
Your answer
Mother's Phone Number
*
Your answer
Father's Name
*
Your answer
Father's Email Address
*
Your answer
Father's Phone Number `
*
Your answer
Tentative Start Date
*
Your answer
Would you require pick-up
*
Yes
No
Maybe
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