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DePaul's Little Listeners' Summer Play Group
Registration Form - Tuesdays and Thursdays in July (9:30-11am)
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Email
*
Your email
Parent/Guardian Name
*
Your answer
Parent/Guardian Contact Phone Number
*
Your answer
Address
*
Your answer
Child's Name
*
Your answer
Child's Date of Birth
*
MM
/
DD
/
YYYY
Does your child have hearing loss?
Yes
No
Maybe
Other:
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Does your child have any allergies?
Yes
No
Maybe
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How did you hear about Little Listeners?
Your answer
Someone from DePaul School will be in contact with you to finalize registration. Thank you!
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