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Parents:     Child:       Child DOB:  
Gender:        School Grade:       School:

Street:   City, State, Zip:  Phone:
Dad's Phone:     Employer:   Occupation:
Mom's Phone:   Employer:   Occupation:

Emergency Name:   Phone #:
Family Doctor:        Phone #:

 Class:     Register Date:       Register #:  
 Paid For?        Notes:      Email:
T-Shirt Size:        

Current Safety Village Registration *
ClassRegister DateRegistration NumberPaid For?
00016/4/2023 10:57:34 AM30439045Y
00056/3/2023 4:41:33 PM39277249Y
00054/22/2023 9:03:44 AM50098187Y
00044/22/2023 2:19:37 PM74560364Y
00054/9/2023 5:49:43 AM78980855Y
00064/9/2023 5:54:10 AM89500801Y
00074/14/2023 8:20:58 PM131639972Y
00014/21/2023 8:39:29 PM137918463Y
00055/9/2023 11:01:15 AM146930377Y
00015/7/2023 2:51:14 PM159298740Y
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* When 1 class is listed and payment is shown as recieved, your child is completely registered for that class. You will also receive a confirmation email when this happens.

Class History
Class IDClass AgesSessionStart DateEnd DateMax StudentsActiveNotes
0006Age 8-10Afternoons07/10/202307/14/202316N2023 - PM class for 8-10 year olds
0007Age 5-7Mornings07/10/202307/14/202320N2023 - AM class for 5-7 year olds
0004Age 5-7Mornings06/19/202306/23/202320N2023 - AM class for 5-7 year olds
0005Age 5-7Afternoons06/19/202306/23/202320N2023 - PM class for 5-7 year olds
0001Age 5-7Mornings06/12/202306/16/202320N2023 - AM class for 5-7 year olds
0003Age 5-7Afternoons06/12/202306/16/202320N2023 - PM class for 5-7 year olds
0008Age 5-7Mornings06/27/202207/1/202220N2022 - AM class for 5-7 year olds
0009Age 5-7Afternoons06/27/202207/1/202220N2022 - PM class for 5-7 year olds


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