Today's Date (MM/DD/YYYY)
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Child's Name
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Date of Birth (MM/DD/YYYY)
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Age
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Grade (next school year)
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Additional Information (allergies, other health concerns, etc.)
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Second Child's Name
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Date of Birth (MM/DD/YYYY)
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Age
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Grade (next school year)
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Additional Information (allergies, other health concerns, etc.)
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Third Child's Name
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Date of Birth (MM/DD/YYYY)
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Age
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Grade (next school year)
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Additional Information (allergies, other health concerns, etc.)
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Name of Parent(s)/Guardian(s)
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Address
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Street Address
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Address Line 2
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City
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State
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Postal / Zip Code
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Country
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Phone Number
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Cell Phone Number (optional)
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Email (optional)
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I am willing to:
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Assist
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Volunteer
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