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Child's Fist Name Middle Name Last Name (with space)*  
Fathers Name *  
Mothers Name *  
Guardian's Name *  
Fathers and Mothers Occupation *  
Child's Date Of Birth *  
Child's Height *  
Child's Weight *  
Child's Blood Grp *  
Child's Other Description *  
Email Address *  
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Child's Present Address  
Child's Permanent Address  
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