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Magen David Adom
Club Chaverim at XFactor
Sunday, January 26, 2025
•
26 Tevet 5785
12:00 PM - 2:00 PM
XFactor 4 Oak Creek Plaza, Mundelein, IL
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Parent First Name:
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Total Number of Children Attending:
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1
2
3
4
5
CHILD 1 INFORMATION
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Child's First Name:
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Child's Last Name:
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Child's Grade:
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Does this child have any food allergies?
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Yes
No
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Please explain this child's food allergies below
CHILD 2 INFORMATION
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Child's First Name:
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Child's Last Name:
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Child's Grade:
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Does this child have any food allergies?
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Yes
No
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Please explain this child's food allergies below
CHILD 3 INFORMATION
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Child's First Name:
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Child's Last Name:
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Child's Grade:
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Does this child have any food allergies?
Please Select One
Yes
No
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Please explain this child's food allergies below
CHILD 4 INFORMATION
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Child's First Name:
*
Child's Last Name:
*
Child's Grade:
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Does this child have any food allergies?
Please Select One
Yes
No
*
Please explain this child's food allergies below
CHILD 5 INFORMATION
*
Child's First Name:
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Child's Last Name:
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Child's Grade:
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Does this child have any food allergies?
Please Select One
Yes
No
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Please explain this child's food allergies below
Total Amount Due:
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Wed, January 22 2025
22 Tevet 5785
Today's Calendar
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Wed, January 22 2025 22 Tevet 5785
