GIFT OF CHRISTMAS REGISTRATION FORM

Child's Details

Child's Name *

First

Last

Birthdate *

Allergies? *NoYes

Which allergies? *

Child's Grade *Kindergarten1st2nd3rd4th

Parental Details

Guardian's Name *

First

Last

Email *

Address *

Address Line 1

Address Line 2

City

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Zip Code

Phone *

Please list any additional adults & their relationship to your child that will be authorized to pick up your child:

Please list any other special needs your child might have:

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