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* 1. Child's Name 

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* 2. Child's Grade (Fall 2016)

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* 3. Child's School 

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* 4. Child's T-Shirt Size

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* 5. Special Needs, Concerns or Comments

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* 6. Parent's Name

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* 7. Parent's Cell #

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* 8. Parent's Email Address

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* 9. Campus Attended 

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* 10. Preferred Service Time for Child to be Scheduled in Treehouse:

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