ASO Kids Club Membership Form
For the Child to fill out with their Parent or Guardian.
Sponsored by Alford Orthodonics and Bettagere Orthodontics
www.alfordorthodontics.com
Child's First Name *
Child's Last Name
Parent / Guardian's First Name
Parent / Guardian's Last Name
Child's Age *
Email *
Address
City
State
Zip Code
What is your favorite Instrument?
What hobbies do you enjoy?
What is your favorite piece of music?
What is your favorite food?
What is your favorite color?
What do you want to be when you grow up?
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