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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?
00035/1/2024 7:37:25 AM12826306Y
0001, 0003, 00044/24/2024 3:15:27 PM117173969N
00074/12/2024 3:48:09 PM143710401Y
00014/25/2024 12:57:53 PM146740069Y
00014/25/2024 1:02:04 PM156805251Y
00054/28/2024 8:01:21 AM184623290N
00064/12/2024 1:38:01 PM227100877Y
00014/15/2024 6:41:49 PM260918752Y
00035/9/2024 2:34:15 PM263789576N
00054/11/2024 9:20:53 PM295649836Y
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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 8-10Afternoons07/08/202407/12/202416Y2024 - PM class for 8-10 year olds
0007Age 5-7Mornings07/08/202407/12/202420Y2024 - AM class for 5-7 year olds
0004Age 5-7Mornings06/24/202406/28/202420N2024 - AM class for 5-7 year olds
0005Age 5-7Afternoons06/24/202406/28/202420Y2023 - PM class for 5-7 year olds
0001Age 5-7Mornings06/17/202406/21/202424N2024 - AM class for 5-7 year olds
0003Age 5-7Afternoons06/17/202406/21/202420Y2024 - 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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