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Child Care Form

Please fill out the following form
about your child in the Babysitting Hall in Ramadan Iftar on Aril 7th, 2023.

Mom's Full Name

Email

Phone

1st Child's Name

2nd Child's Name

Age of first child (Date of Birth)

Age of 2nd child (Date of Birth)

Is your child suffering from a medical condition, illness, or injury? *

No

Yes

If you answered yes to any question, please elaborate. If you have any other comments you want to add, please write them down.

Initials

I declare that the info I’ve provided is accurate & complete

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