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

Elementary School Attending:

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...