NGSSH Spring Dance Childcare Registration
Childcare Registration 
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Parents/ Guardian name *
Parent/ Guardian Phone Number  *
Number of Children below 12 *
Does any child have allergies or dietary restrictions? *
If yes, please specify the child’s age and the allergy/restriction *
Does any child have medical or special care needs we should be aware of? *
If yes, please provide details
Emergency Contact Name & Phone number (if different from parent/guardian)
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