Address: Unit # Street Number Street Name
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Emergency Contact: Name Telephone First Language spoken at home
For children's program's only Program Information
Child's Name Child's Date of Birth Adult Program Childrens Program
Child's Name Child's Date of Birth Program Please complete Home work Club Summer Literacy Job Club English Cafe Citizenship Child Minding Training Nutrition Tutoring French Arabic Parent Discussion Music Tutoring Traning Drop In Internet Cafe
Child's Name Child's Date of Birth
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