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Chai 5 - Kids Care

Parent's Info
Full Name*

First Name Last Name
E-mail*
Phone Number*

Area Code Phone Number
Child's #1 Information
Full Name*

First Name Last Name
Grade*
School*
Child #2 Information
Full Name

First Name Last Name
School
Grade
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Number of children attending
Total

$0.00

Payment

Credit Card Pay at door

Postal / Zip Code

Country

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