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First Name:	*	(Primary Contact)
Last Name:	*	(Primary Contact)
Middle Name:
Prefix:
Nickname:
Language:
Birthdate:
Gender:
Grade:
Address:	*

City:	*
Country:
State:	*
Zip:	*
Residency:
Phone:		(ex: XXXXXXXXXX)
Health Notes:
Emergency Contact:
Emergency Phone:		(ex: XXXXXXXXXX)
School:
Neighborhood:


Email:	*
Password:	*
Verify Password:	*
	Password Requirements: Between 8-16 characters, 1 alphabetic, 1 numeric, 1 special character (!@#^*-=), no spaces
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