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Section A - Parent(s)
Parent # 1
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Phone
Email
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Address
*
Address Line 1
City
State / Province / Region
Postal Code
Parent # 2
Full name
Phone
Email
Address
Address Line 1
City
State / Province / Region
Postal Code
Section 2 - Choice of workshops
Which workshop(s) would you like to attend?
*
Expecting Baby Animated by a Birth Companion
To the Rhythm of the Music
Tandem, a Winning Team
Mommy, Daddy, I’m going to Kindergarten
Les Dynamites!
Travelling Through Words
Frog and Twig
Sing Along/Chantons ensemble
Babies and Toddlers Talk
Parenting Support Group-Coffee Chat
Section C - Kid(s)
Kid # 1
Full name
*
Date of birth
*
Does the child have any allergies, chronic illnesses or medical conditions that we should know about?
*
Yes
No
If yes, please specify:
*
Kid # 2
Full name
Date of birth
Does the child have any allergies, chronic illnesses or medical conditions that we should know about?
*
Yes
No
If yes, please specify:
Kid # 3
Full name
Date of birth
Does the child have any allergies, chronic illnesses or medical conditions that we should know about?
Yes
No
If yes, please specify:
Section D - Emergency contact
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Relationship to parent and/or child:
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Email
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