BMELA Child Care Form

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BMELA Child Care Form

BMELA Child Care Form

Please fill out and submit this form to register your child(ren) for child care (limited to ages 4-11).

4Questions

1
Name of Parent/Guardian Attending the Service
First Name
Last Name
2
Email
example@example.com
3
Cell Number
Please enter a valid phone number.
4
List the Name(s) and Ages of Your Child(ren)
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Ok
Ok
Should be Empty:

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