Alpha & Omega
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Please complete the following form for each child you have enrolled in Alpha & Omega. Thank you!
Basic Information
Child's Name
*
Birthday
*
Allergies
*
Parent/Guardian Name
*
Address
*
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AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Cell Phone
*
Home Phone
*
Email
*
This address will receive a confirmation email
Permission to use photos online and in print
*
Please select one option.
Yes
No
Select Option
Yes
No
Submit
Description
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