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After School Activity with I-Engineer
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* Indicates required question
1. Parent's Name
*
Your answer
2. Contact Number
*
Your answer
3. E-mail Address
*
Your answer
4. Complete Home Address (including ZIP CODE)
*
Your answer
6. Kid's Name
*
Your answer
6. Kid's School
*
Your answer
7. Kid's Age
*
Ages 3-5
Ages 6-12
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