Kidzwhiz Student Registration Form

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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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