Childs Name (required)

    Child's Age (required)

    Age Category Entered (required)

    3-6 mths6-9 months9-12 months12-18 months

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    Disclaimer: By signing this form you confirm that you have parental responsibility for the child mentioned.
    You agree to any images of your child being used on carnival literature (website, printed etc

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    Please Enter Todays Date (required)