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ECFE Registration Form

ECFE Registration Form

Child's Name______________________________Birthdate_____________________Age________

Parent(s) attending classes w/child - Name(s)____________________________________________

Address__________________________________City__________________State______Zip______

Phone (home)____________________Work or Cell #______________________________________
Email:___________________________________________________________________________

Register for:  Class Title:_____________________________Day & Time______________________

                    Class Title:_____________________________Day & Time______________________

*If you desire care for siblings, please list their names and ages:____________________________                                                                                                                       

Registration forms can also be picked up at Pequot Lakes Family Center or call 218-562-7520.