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Contact Information

* Parents First Name
* Parent's Last Name
* Child's First Name
* Child's Last Name
* Parent's E-mail Address
* Parent's Home Phone
* County you reside in
* City you reside in
* Home Zip Code
* School your child attends
* Child's grade





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1801 Boy Scout Drive, Fort Myers, FL 33907
239.936.8072 Fax 239.936.7864


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