• First Name: *  (Primary Contact)
    Last Name: *  (Primary Contact)
    Language:
    Birthdate:
    Gender:
    Grade:
    Address: *
    City: *
    Country:
    Province: *
    Postal Code: *
    Residency:
    Phone: *  (ex: XXXXXXXXXX)
    Health Notes:
    Emergency Contact:
    Emergency Phone:  (ex: XXXXXXXXXX)
    School:
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    Email: *
    Password: *  
    Verify Password: *  
    Password Requirements: Between 8-16 characters, 1 alphabetic, 1 numeric, 1 special character (!@#^*-=), no spaces
    Family Members: