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The Blue Mountains Public Library, Kids' Club Registration - Session 1
Please use one form for each household.
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* Indicates required question
Email
*
Your email
Parent / Guardian Name
*
Your answer
Parent / Guardian Address
*
Your answer
Parent / Guardian Phone Number
*
Your answer
Child 1 - Name
*
Your answer
Child 1 - Age as of September 1, 2021
*
Your answer
Child 1 - School
*
Your answer
Child 1 - Grade
*
Your answer
Child 2 - Name
Your answer
Child 2 - Age as of September 1, 2021
Your answer
Child 2 - School
Your answer
Child 2 - Grade
Your answer
Child 3 - Name
Your answer
Child 3 - Age as of September 1, 2021
Your answer
Child 3 - School
Your answer
Child 3 - Grade
Your answer
Child 4 - Name
Your answer
Child 4 - Age as of September 1, 2021
Your answer
Child 4 - School
Your answer
Child 4 - Grade
Your answer
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