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Kidzwhiz Student Registration Form
Matthew (
matthew@kidzwhiz.com
) will confirm the availability and total tuition after the registration is submitted.
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* Indicates required question
Student First Name
*
Your answer
Student Last Name
*
Your answer
Student Email
*
Your answer
Student Birthday
*
MM
/
DD
/
YYYY
Street Address
*
Your answer
City
*
Your answer
Postal Code
*
Your answer
Allergies (please specify)
Your answer
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