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Child Information
Child's Name
Birthday
Gender
Address
Phone
Parent Information
Mother's Name
Email
Address
Home/Mobile Phone
Work Phone
Father's Name
Email
Address
Home/Mobile Phone
Work Phone
Legal Guardian or Custodial Other Than Parent Name (if applicable)
Home/Mobile Phone
Legal Guardian or Custodial Other Than Parent Name (if applicable)
Home/Mobile Phone
Persons Authorized to Pick Up Child at The Treehouse Growing and Learning Center & Study Loft
Name
Home/MobilePhone
Name
Home/MobilePhone
Family History
Marital Status of Parents
Married
Divorced
Separated
Widowed
Single
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