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FRIENDLY FACES – WAITING LIST FORM
Child's name:
Date of Birth
Parent's name:
Street address
ZIP Code
Email address:
Contact number:
Number of days
Specific days
Commencement date
Is your child immunised? *
Yes
No
Does your child attend other centers or care? *
Yes
No
How did you hear about us?
12 + 8 - 6
