GETTING TO KNOW YOUR CHILD 
Help us learn all we need to know to help your child have an enjoyable and successful after school program experience.
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Email *
STUDENT'S NAME
GRADE
DATE OF BIRTH *
MM
/
DD
/
YYYY
NAME OF SCHOOL *
HOME/CELL PHONE
PRIMARY PARENT/GUARDIAN NAME
WORK PHONE/CELL PHONE
HOME ADDRESS
EMERGENCY CONTACT NAME & PHONE NUMBER
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