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Home/Test Coaching Program01/ BHAVIN SAVALIYA

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Child Name*

Child Date Of Birth*

School Name

Club Name

Does your child have any medical conditions (Asthma, Allergies Etc?)

Address*

Do you consent to us using your child’s photo on our social media and/or website?*

Yes

Permission to administer first aid if needed*

Yes

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Total Amount Payable $0.00

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