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Child's Full Name
Child's Current Grade (if applicable)
Child's Date of Birth
Child's B-form Number/ Passport Number
Home Address
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If Attended (Reason of Leaving )
Medical Information (allergies, precautions, diagnosis, therapies, etc)
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Phone No.
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I hereby declare that the details furnished above are true and correct to the best of my knowledge and belief and I undertake to inform you of any changes therein, immediately. In case any of the above information is found to be false or untrue or misleading or misrepresenting, I am aware that I may be held liable for it.
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