High Country KIDDO Program Term 4 2021 Registration

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* 1. Childs Full Name:

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* 2. Date of Birth:

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* 3. Gender:

Female

Male

Other

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* 4. Left or Right handed:

Left

Right

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* 5. Guardians Name:

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* 6. Contact Number:

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* 7. Email:

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* 8. How did you hear about us?

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* 9. Do you consent to photography taking place at this event?

Yes

No