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* 1. Child's Name and Birthdate:

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* 2. Is your child male or female?

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* 3. Is this your first year registering with FCHA?

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* 4. Home Address:

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* 5. Home Phone Number:

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* 6. Cell Phone Number:

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* 7. Email Address:

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* 8. Which program would you like to register for?

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