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Child's Information*
Grade entering in the Fall* Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade
Child's Information
Grade entering in the Fall Kindergarten 1st Grade 2nd Grade 3rd Grade 4h Grade 5th Grade
Grade entering in the Fall Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade
Parent/Guardians Names*
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Emergency Contact*
Allergies / Medical Conditions
Home Church
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Parent / guardian signature*
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