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Home
KPC Kids' Club Registration
About Us
Leadership
Events
Contact
Parent/ Guardian First name
Parent/ Guardian Last name
Relationship to Student
Email
Phone
Address
Student Name (Nickname)
Emergency Contact Name and Phone Number
Relationship To Student
Secondary Emergency Contact (Optional)
Student's Birthday
Month
Day
Year
Grade/School
Allergies (food, medication, environmental)
Special Needs or Accommodations
Academic Needs
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