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Tuesday, 1 October, 0030
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Gender: 
Girl
School: 
12
Emergency Contact: 
24
Emergency Contact Phone Number: 
34
Parent / Guardian: 
Yessica
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Relationship of Emergency Contact to the Child: 
11
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: 
Rodie