INFORMATION REQUIRED UPON REGISTRATIONSession Date: Sept-Nov;
Jan-Mar; Apr-June; Summer
Community: Riverbend Strathcona Queensland Langdon Braeside
Child’s Name___________________________________________ Age ____
Parents Name
__________________________________________________
Address
_______________________________________________________
Telephone Home
_______________________ Work ____________________
E-mail Address
__________________________________________________
Allergies________________________________________________________
Payment sent to LBM Services _______ Cash _______ Chq ________________
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