Application (For TIDDLEE Parent)

Father’s or Guardian 2 Information

Name :

Employed by :

Address of Employment :

Work Phone :

Cell Phone :

Email :

Relationship to child :

Unique ID :

Date of Admission :

By signing below the parent or guardian fully understands and agrees to the entire content of the facility’s policies and Terms & Conditions. The Parent / Guardian ensures that the data provided by them is accurate.

Digital Signature 1

Mother's/Guardian 1 Signature

Date:

Digital Signature 2

Father's/Guardian 2 Signature

Date:

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