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Registration Form

Childes Last Name:
Child's First Name
Child's Middle Name
Child's D.O.B
Child's Sex	Male Female
Parent / Guardian's Last Name
Parent / Guardian's First Name
Child's Address
Lot or Apt Number
City
Zip
Phone number
Cell Phone
Email address
This child is a resident of Allegan County	Yes No
I would like to receive additional school readiness information directly from my local school district	Yes No
School District