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Register your child

Name*
First Last
Best way to contact me*
- Phone
- Email
Phone Number*
Email*
Name of children and birthdate(s):*
Contact Stacy Richards at srichards@childrensvillagelssin.org for more information.

333 East Lewis Street | Fort Wayne, Indiana 46802 | (260) 426-3347 | Fax (260) 424-2248