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名 First name

First name?

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ミドルネーム Middle

お名前 Last Name

Last name?

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住所 Address

Please provide a valid address.

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Please add mom's name.

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Please add mom's cell #.

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Please add an email.

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年月日 Birthday

Please add Birthday as YYYY/MM/DD.

Age is calculated from this entry.

Age

Please add age.

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性別 Gender 女 Girl 男 Boy

Please select gender.

Password

Please add a password.

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以前通ったことのあるスクール School history

健康上の問題、アレルギーなど Allergies

何かありましたらご記入ください Medical history

オムツ?

Early Dropoff?

Bus Svc?

Lunch Svc?

Afterschool?

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