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Save the Children KinderBoost
Please complete this form to enroll your child into the STC Summer Program
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* Indicates required question
Child's Name (First and Last)
*
Your answer
Child's Date of Birth
*
MM
/
DD
/
YYYY
Child's Physical Address
*
Your answer
Parent Guardian Name(s)
*
Your answer
Phone Number
*
Your answer
Child's Elementary School
*Based on physical address and school attendance zone
*
Brodhead Elementary
Mt. Vernon Elementary
Roundstone Elementary
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