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* 1. Site (Lugar)

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* 2. Parent/Guardian Name (Nombre del Padre/Madre/Tutor)

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* 3. Child's Name (Nombre del Niñe)

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* 4. Child's Age (Edad del Niñe)

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* 5. Email (Correo Electrónico)

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* 6. Phone Number (Número de Teléfono)

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* 7. Primary Language (Idioma Principal)

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