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(For Safari only, Use datepicker or enter in YYYY-MM-DD format for Child's DOB)
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MaleFemale
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YesNo
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YesNo
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I agree to accept responsibility for costs incurred on my behalf in securing medical treatment and associated services for the above mentioned child requiring medical treatment or in the case of a medical emergency.I also consent to the Shine Chinese Community School to provide first aid.I understand that Shine Chinese Community School does not provide automatic personal injury or liability insurance for student accidents which are inflicted by the students themselves.
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