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Parent 1
Parent 2
Emergency Contact
Health
Swim
Pick-Up
Waiver
Step
Payment
Ohio Child Care Registration
First Day Attending Program*
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member-Id
Today's Date
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Child's Name*
Child's Date of Birth*
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Child's Gender*
Age*
School*
How many people live in the home?*
Child's Race*
White/Caucasian
Black/African American
American Indian
Hispanic
Multi-Racial
Native Hawaiian/Pacific Islander
Asian
Other
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