New reg – Family Resource Centre

DBTEST – New Member Registration

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Name *

First

Last

Email Email date

New Members date of birth *

Email address *

Number of children potentially attending

Parent/Guardian Name *

First

Last

Parent/Guardian Email *

Parent/Guardian Phone *

Permission & Agreement *

I give the Family Resource Centre permission to publish photos of myself and the children in my care for promotional and informational use.

Email *

Family Resource Centre

Twenty Twenty-Five

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