Registration

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* 1. Name:

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* 3. Phone:

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* 4. Please check the weekday timeframe(s) you'd be available to participate in a group:

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* 5. Please check the format you'd prefer:

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* 6. How many children do you care for?

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* 7. How old are the children you care for?

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* 8. Where do your parent(s) or other adult(s) you’re caring for live?

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