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First Name
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Last Name
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Phone Number
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Email Address
Emergency Contact
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Contact Name
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Contact Number
Child’s Information
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First Name
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Last Name
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Age
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My child is a
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My child is allergic to
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Mini Careplan
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Signs of a serious reaction in my child:
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If my child has any of the above serious reactions:
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If my child has any of the above mild reactions:
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