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Enroll A Child Form
Child's Name
(required)
Gender
(required)
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Date of Birth
(required)
Parent/Guardian's Name
(required)
Home Address
(required)
Primary Telephone Number
(required)
Preferred Language (Child)
(required)
English
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Other
Preferred Language (Parent/Guardian)
(required)
English
Spanish
Other
Have you ever contacted us before?
(required)
Yes
No
Please let us know how you heard about BBBS of SW Colorado:
Why does this child need a mentor?
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