Parent's First Name

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* 1. Parent's First Name

Parent's Last Name

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* 2. Parent's Last Name

Address (Please confirm Vermont residency.)

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* 3. Address (Please confirm Vermont residency.)

Email Address (Enter valid email to receive the discount code.)

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* 4. Email Address (Enter valid email to receive the discount code.)

Number of children receiving learn-to package discount

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* 5. Number of children receiving learn-to package discount

Child #1: Enter first and last name, age, and school for first child.

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* 6. Child #1: Enter first and last name, age, and school for first child.

Child #2: Enter first and last name, age, and school for second child.

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* 7. Child #2: Enter first and last name, age, and school for second child.

Child #3: Enter first and last name, age, and school for third child.

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* 8. Child #3: Enter first and last name, age, and school for third child.

Child #4: Enter first and last name, age, and school for fourth child.

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* 9. Child #4: Enter first and last name, age, and school for fourth child.

Child #5: Enter first and last name, age, and school for fifth child.

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* 10. Child #5: Enter first and last name, age, and school for fifth child.

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