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You Belong! Early Learning Center Enrollment
Please fill out this form to enroll your child with us
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Child's
Name
*
Your answer
Child's Age
*
Your answer
Parent/Guardian's Name
*
Your answer
Parent Contact Information
Phone Number, Email Address
Your answer
Medical Information (e.g. allergies, medication requirements)
*
Your answer
Days and Times of Attendance
*
Your answer
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