PORT CITY KIDS
CLASS REGISTRATION
PLEASE SELECT ONE *
Required
DATE
MM
/
DD
/
YYYY
NAME OF CHILD #1 *
CLASS ROOM *
NAME OF CHILD #2
CLASS ROOM
Clear selection
NAME OF CHILD #3
CLASS ROOM *
NAME OF PARENT(GUARDIAN) *
PARENT(GUARDIAN) CONTACT NUMBER *
ANY SPECIAL NEEDS OR ALLEGERIES for any CHILD? PLEASE DISCLOSE * *
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