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2024 Registration Form for Anshei Lubavitch Daycare Center - Fall 2024
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* Indicates required question
Email
*
Your email
Child's Last Name
*
Your answer
Child's First Name
*
Your answer
Child's Gender
*
Female
Male
Not born yet
Child's Date of Birth
*
MM
/
DD
/
YYYY
How old will your child be in September 2024
*
Your answer
Home phone number
*
Your answer
Mother's name
*
Your answer
Mother's cellphone number
*
Your answer
Mother's e-mail address
*
Your answer
Father's Name
*
Your answer
Father's cellphone number
*
Your answer
Father's e-mail address
*
Your answer
Choose which class child will be in September 2024
*
Infant Room (under 12 months in September 2024) (Saddle Brook Location Only)
Aleph Class (1 year - 2 years by September of 2024) (Saddle Brook Location Only)
Bet Class (2 years - 3 years by September of 2024)
Gimmel Class Class (3 years - 4 years by September of 2024)
Daled Class (4 years - 5 years by Sptember of 2024)
Does your child have any health or behavioral conditions that we should be aware of?
Yes
No
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Please provide any relevant information about their condition
Your answer
A copy of your responses will be emailed to the address you provided.
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