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Online Childcare Reservations
Please fill in all information.
* indicates a required field.
*Name of event:
*Date of event:
*Parent or guardian:
*Contact phone:
*Contact email:
Other adults approved to pick up child:
*Number of children to be registered
1
2
3
4
5
*List child's name (first and last), age, allergies/medical conditions and any special needs for each child.
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