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After Care Sign-Up

After Care Sign-Up

Child's Name
Child's Name
First
Last
Address
Address
City
State/Province
Zip/Postal
Country

Parent's Names

Father's Name
Father's Name
First
Last
Emergency Contact:
Emergency Contact:
First
Last
Mother's Name
Mother's Name
First
Last

COST: $8.00 per hour | 3:30 pm – 6:00 pm

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