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Thank you {{_name}}. We will be contacting you via {{parents_email}} or {{parents_cell_phone}}, regarding {{first_name}}'s enrollment into Chappelle Daycare.
1
1
  • 1
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    Parent's name
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    Child Info
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    Parents/Guardian information
  • 4
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    Emergency Contact
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    Health History
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Welcome to Chappelle Daycare. This is our online registration form
Pleased to meet you {{_name}}.

Kindly fill in your child details
Please, provide parents/guardian information
regarding {{first_name}}'s enrolment.

Home Address

Business Information

Signature (Parent/Guardian 1) - I agree that my typed name will be as valid as a handwritten signature to the extent allowed by local law *

Please, provide emergency contact information
regarding {{first_name}}'s enrolment.

Home Address

Alternative emergency contact information
regarding {{first_name}}'s enrolment.

Home Address

Does {{first_name}}'s has any allergy or food restrictions? Please tell us
Finally {{_name}}, we would like to know about {{first_name}}'s health

Doctor's Address

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Thank you {{_name}}. We will be contacting you via {{contact_method}}, regarding your {{product_selection}}.
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    Step 4
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Welcome to Chappelle Daycare. This is our online registration form
Pleased to meet you {{_name}}.

Kindly fill in your child details
Please give a short description of the requirements
regarding your
{{product_selection}}.
Thank you {{_name}}.
How would you like to be contacted?
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Opening Hours: Mon-Fri, 6am-6pm

Registration Form

Thank you {{_name}}. We will be contacting you via {{parents_email}} or {{parents_cell_phone}}, regarding {{first_name}}'s enrollment into Chappelle Daycare.
1
1
  • 1
    Step 1
    Parent's name
  • 2
    Step 2
    Child Info
  • 3
    Step 3
    Parents/Guardian information
  • 4
    Step 4
    Emergency Contact
  • 5
    Step 5
    Add Another Emergency Contact
  • 6
    Step 6
    Allergy and Food Restrictions
  • 7
    Step 7
    Health History
0%
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1
fadeIn
fadeOut
Hi

Welcome to Chappelle Daycare. This is our online registration form
Pleased to meet you {{_name}}.

Kindly fill in your child details
Please, provide parents/guardian information
regarding {{first_name}}'s enrolment.

Home Address

Business Information

Signature (Parent/Guardian 1) - I agree that my typed name will be as valid as a handwritten signature to the extent allowed by local law *

Please, provide emergency contact information
regarding {{first_name}}'s enrolment.

Home Address

Alternative emergency contact information
regarding {{first_name}}'s enrolment.

Home Address

Does {{first_name}}'s has any allergy or food restrictions? Please tell us
Finally {{_name}}, we would like to know about {{first_name}}'s health

Doctor's Address

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