Date of Birth: 
Saturday, 7 February, 0026
Other information: 
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Gender: 
Boy
School: 
55
Emergency Contact: 
46
Emergency Contact Phone Number: 
44
Parent / Guardian: 
Jocelynn
48
25
85
Relationship of Emergency Contact to the Child: 
70
School Year: 
12
I agree that my child may receive emergency medical treatment by a trained member of staff or medical practitioner if needed: 
Doctor Address: 
Jenavieve