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Child 1 Name/age

Current grade

Allergies, medical conditions, or special needs

Child 2 Name/age

Current grade

Allergies, medical conditions, or special needs

Child 3 Name/age

Current grade

Allergies, medical conditions, or special needs

Child 4 Name/age

Current grade

Allergies, medical conditions, or special needs

Parent(s) name

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Phone

Address

In case of emergency/ Relationship

Phone

Description

June 9-13

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