Date of Birth: 
Wednesday, 6 February, 0097
Other information: 
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Gender: 
Girl
School: 
41
Emergency Contact: 
59
Emergency Contact Phone Number: 
83
Parent / Guardian: 
Kyleigh
96
31
80
Relationship of Emergency Contact to the Child: 
72
School Year: 
10
I agree that my child may receive emergency medical treatment by a trained member of staff or medical practitioner if needed: 
Doctor Address: 
Devyn