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"Camp Curious" Preschool Registration
Email address *
Untitled Title
Camper's Name *
Your answer
Gender *
Date of Birth (Child must be 2 years old by June 1, 2019) *
MM / DD / YYYY
Your answer
Address *
Street, City, State, Zip
Your answer
Parent's Name *
Your answer
Parent's Primary Phone *
Your answer
Parent's Secondary Phone
Your answer
Parent's Email *
Your answer
I authorize the following people to pick up my child in case of emergency. *
Names & Phone Numbers
Your answer
Pediatrician Name
Your answer
Pediatrician Phone
Your answer
If you child has food or environmental allergies, asthma, or other chronic condition, you are required to complete a Health Management Plan in the Preschool office.
What would you like us to know about your child?
Your answer
Has your child been to preschool before?
If yes, where?
Your answer
Is your child potty-trained?
Siblings and Ages:
Your answer
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