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How many children are you registering?
1
2
3
4
5
Child's Information
First Name
*
Last Name
*
Birth Date
*
Month
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
Day
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31
Year
Year
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
2026
Register to the following event(s)
*
Magical Moments with Lily - Wednesday, June 18, 10:30-11:30 am
Petting Zoo and Crafts - Tuesday, June 24, 10:30-11:30 am
Participant Fee
$
Child 2
First Name
*
Last Name
*
Birth Date
*
Month
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
Day
1
2
3
4
5
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21
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30
31
Year
Year
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
2026
Register to the following event(s)
*
Magical Moments with Lily - Wednesday, June 18, 10:30-11:30 am
Petting Zoo and Crafts - Tuesday, June 24, 10:30-11:30 am
Participant Fee
$
Child 3
First Name
*
Last Name
*
Birth Date
*
Month
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
Year
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
2026
Register to the following event(s)
*
Magical Moments with Lily - Wednesday, June 18, 10:30-11:30 am
Petting Zoo and Crafts - Tuesday, June 24, 10:30-11:30 am
Participant Fee
$
Child 4
First Name
*
Last Name
*
Birth Date
*
Month
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
Year
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
2026
Participant Fee
$
Register to the following event(s)
*
Magical Moments with Lily - Wednesday, June 18, 10:30-11:30 am
Petting Zoo and Crafts - Tuesday, June 24, 10:30-11:30 am
Child 5
First Name
*
Last Name
*
Birth Date
*
Month
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
Year
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
2026
Participant Fee
$
Register to the following event(s)
*
Magical Moments with Lily - Wednesday, June 18, 10:30-11:30 am
Petting Zoo and Crafts - Tuesday, June 24, 10:30-11:30 am
Parent's Information
First Name
*
Last Name
*
Street Address
*
City
*
Postal Code
*
State/Province
*
Phone Number
*
Email
*
Alef Preschool of Palm Beach
info@alefpalmbeach.com
|
561-489-6020
|
165 Bradley Place, Palm Beach, FL
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