AFTER SCHOOL REGISTRATION | Chabad of S. Clara

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To register, please take the time to fill out the information below.

Child's First & Last Name

Child's Birthday

Grade Entering in 2022

Child's Age

Child's Gender

Does your child have any allergies?

Please explain allergies, symptoms, and severity...

Does your child have any health conditions or behavioral challenges?

Please explain any health conditions or behavioral challenges...