ACE CO-OP
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Family Registration Form
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Father's Name
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First
Last
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Mother's Name
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First
Last
Email
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Primary Phone Number
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Please list the phone number you would prefer we use on co-op Fridays if we need to reach you.
Mom Cell (if not Primary)
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Dad Cell (If Not Primary)
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Address
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Line 1
Line 2
City
State
Zip Code
Country
My Family Plans to Attend Co-op:
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All Day
Morning Only
Afternoon Only
Other (Please Explain in Additional Information Box Below)
Child 1 First Name
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Child 1 Date of Birth (MM/DD/YYYY)
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Child 1 grade as of September 30, 2018
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Nursery
PreK
K
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Child 1 Allergies/Special Needs/Notes
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Child 2 first Name
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Child 2 Date of birth (MM/DD/YYYY)
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Child 2 Grade As of September 30, 2018
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(Blank)
Nursery
PreK
K
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Child 2 Allergies/Special Needs/Notes
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Child 3 first Name
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Child 3 Date of birth (MM/DD/YYYY)
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Child 3 grade as of September 30, 2018
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(Blank)
Nursery
PreK
K
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Child 3 allergies/special needs/notes
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Child 4 first Name
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Child 4 Date of birth (MM/DD/YYYY)
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Child 4 grade as of September 30, 2018
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(Blank)
Nursery
PreK
K
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Child 4 Allergies/Special Needs/notes
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Child 5 first Name
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Child 5 Date of birth (MM/DD/YYYY)
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Child 5 grade as of September 30, 2018
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(Blank)
Nursery
PreK
K
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Child 5 Allergies/special needs/notes
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Child 6 first Name
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Child 6 date of birth (MM/DD/YYYY)
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Child 6 Grade As of September 30, 2018
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(Blank)
Nursery
PreK
K
1
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Child 6 allergies/special needs/notes
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Child 7 first Name
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Child 7 Date of birth (MM/DD/YYYY)
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Child 7 Grade as of September 30, 2018
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(Blank)
Nursery
PreK
K
1
2
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Child 7 allergies/special needs/notes
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Child 8 first Name
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Child 8 date of birth (MM/DD/YYYY)
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Child 8 Grade As of September 30, 2018
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(Blank)
Nursery
PreK
K
1
2
3
4
5
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7
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Child 8 allergies/special needs/notes
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Additional Information
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Please include ANYTHING that you think would be helpful for the Board to know.
Electronic Signature/Date for Mother
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Electronic Signature/Date for Father
*
Submit
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