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Registration Form

Location*

Child's name

First name*

Last name*

Has your child been born? *

Date of Birth*

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If your child has not yet been born, please indicate the due date. Desired date for the child's entry.

Link with the daycare:

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Contact Parents

Parent's name

First name*

Last name*

Email *

Phone

Phone 1*

Other contact

Do you want to add a second contact?

Phone 2*

Thank you! Your message has been successfully sent. We will contact you very soon!

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