Akron Grace E. C. Church
"To Intimately know Christ and make Him fully known"
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Helping Hands DayCare
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Name
Date of Birth
Age
Grade Completed
Address
Parent/Legal Guardian Name
Phone Number
Emergency Contact # 1 Name and Phone Number
Emergency Contact # 2 Name and Phone Number
Name and phone number of the person who will be picking up your child
Any Drug/Food Allergies?
Does your child have any special needs?
Special Requests?
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