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* 1. Child(ren)'s name

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* 2. Center Location

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* 3. At this moment, I plan for my child(ren) to...

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* 4. If in-person programming is available, I would prefer...

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* 5. If in-person programming is not available, our family has...

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* 6. What are your thoughts on teachers/students wearing masks or face shields? Mark all that apply.

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* 7. What other assurances do you need from us to feel comfortable sending your child(ren) to in-person programming?

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