Trial Class Registration
Parent Full Name
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Phone
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Text Opt In
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Email
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Address
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City
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Postal code
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2nd Parent Full Name
2nd Parent Phone
Child Full Name
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Child Gender
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Male
Female
Child's Age
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Child Date of Birth
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Child's Allergies
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Does your child have any conditions that will affect play/learning? Please type YES or NO. If YES, please list conditions.
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Add another child?
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Yes
No
Child 2 Full Name
Child 2 Gender
Male
Female
Child 2 Age
Child 2 Date of Birth
Child 2 Allergies
Child 2 Any conditions that affect play?
How did you hear about us?
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Date Signed
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Parent Signature
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