Outlook & District Playschool Registration Form
Registration form for September-June 2024
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Name of Child *
Date of Birth *
MM
/
DD
/
YYYY
Mailing Address *
Email Address *
Name of Mother *
Mother's Cell Phone Number *
Mother's Home Phone Number
Mother's Work Phone Number
Name of Father *
Father's Cell Phone Number *
Father's Work Phone Number
Father's Home Phone Number
Name and Ages of Siblings
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