How many days would you like to register your child? *
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Parent's name *
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Email Address *
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Best Phone Number To Contact *
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Second best phone number
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Specific Health Information
Instructions on medication needs, allergies, and other important information.
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Payment Methods and other important information.
Please make your check payable to:
Learnika 572 College Ave, Palo Alto, CA 94306
You can also pay by using (650)224-2230 for Zelle or "tony@learnika.com" If you are using PayPal, please send the payment as "family or friends" as PayPal will charge a 3% service fee if not.