2021-2022 Good News Learning Center
Enrollment Form
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Child 1 - Name (first & last) *
Child 1 - Date of Birth *
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YYYY
Child 1 - Gender *
Child 1 - Please describe if the child has any allergies or special needs
Child 2 - Name (first & last)
Child 2 - Date of Birth
MM
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DD
/
YYYY
Child 2 - Gender
Clear selection
Child 2 - Please describe if the child has any allergies or special needs
Child 3 - Name (first & last)
Child 3 - Date of Birth
MM
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DD
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YYYY
Child 3 - Gender
Clear selection
Child 3 - Please describe if the child has any allergies or special needs
Address *
City, State, Zip *
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