Parents Name
First Name
Last Name
Child's Name
Email
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Date of Service Started
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Month
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Day
Year
Date
My Products
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Infants - Part Time
$260.60
$
260.60
Quantity
1
2
3
4
5
6
7
8
9
10
Infants - Full Time
$368.25
$
368.25
Quantity
1
2
3
4
5
6
7
8
9
10
Toddler - Full Time
$331.25
$
331.25
Quantity
1
2
3
4
5
6
7
8
9
10
Toddler - Part Time
$239.54
$
239.54
Quantity
1
2
3
4
5
6
7
8
9
10
Pre School- Full Time
$302.72
$
302.72
Quantity
1
2
3
4
5
6
7
8
9
10
Pre School- Part Time
$209.12
$
209.12
Quantity
1
2
3
4
5
6
7
8
9
10
School Age- Full Time
$204.44
$
204.44
Quantity
1
2
3
4
5
6
7
8
9
10
School Age- Part Time
$153.64
$
153.64
Quantity
1
2
3
4
5
6
7
8
9
10
Summer June 1st - September 1st
$350.00
$
350.00
Quantity
1
2
3
4
5
6
7
8
9
10
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