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T-Spoons Tot Spot Enrollment Form
This form must be filled out in entirety before initial drop-off.
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* Indicates required question
Email
*
Your email
Parents'/Guardians' Full names
*
Your answer
Parents'/Guardians' Cell Phone Numbers
*
Your answer
Emergency Contact Name (list someone other than the parent who is authorized to pick up your child in the event of an emergency):
Your answer
Emergency Contact Relationship to Child:
*
Your answer
Emergency Contact Phone Number
*
Your answer
Children's Names
*
Your answer
Children's Age (minimum age 4 months)
*
Your answer
Is your child fully capable of using the potty him/herself?
*
Yes
No
Other:
List any pertinent information about your child (allergies, preferences, special needs, etc.) :
Your answer
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