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Registration for afternoon program
Daily Schedule: Mon.-Fri. 1:00pm-4:30pm,
Daily snack included
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Child's Information
First Name
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Your answer
Last Name
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Your answer
Date of Birth
*
Your answer
Nickname
If any
Your answer
Allergies or Medical Concerns
Your answer
Name of Child's Doctor
Your answer
Phone number of Child's Doctor
Your answer
Name of school of morning program (if attending)
Your answer
Gender
Female
Male
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Spanish Level
New to Spanish
Some exposure
Fluent comprehension yet responds in English
Fluent Spanish Speaker
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