Your Child's Information

      

Allergies

Child's Primary Doctor

Child's Primary Dentist

Health History

Only pdf, doc and docx file formats are allowed.

Operation/Serious Injuries

Current Medications

Physical Limitations

Dietary Limitation

Are there any activities you would prefer your child NOT to participate in?

Photo Permission

Additional Comments/Information

Parent / Guardian Information

Emergency Contacts - Please list 2 that are NOT Parents

Child Pickup Authorization

NOT Authorized For Pickup

Only pdf, doc and docx file formats are allowed.
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