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Firefly Oasis
~Preserving the Magic of Childhood~

Artistic Enrichment Club Application

For ages 5-12, Teens, & Adults

Student's name*

Birthday*

Month

Day

Year

Parent/Guardian Names

Town*

Email*

Phone

Allergies/Food restrictions*

Preferred afternoons*

Monday

Wednesday

Thursday

Friday

Saturday after 1pm

If interested in weekdays, please share the best time to attend between 1-7pm.

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