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To secure and maintain the services of PROVIDER and the PROVIDER desires to enter into an Agreement of employment with the PARENTS upon the terms and conditions hereinafter set forth. Name of PARENTS: Address(F): , and city State Address:(M): State Zip Home Phone(F): ( Home Phone(M): ( Name of Child(ren): Sex of Child(ren) : Dates of Birth : ) ) - Work ( Work ( ) ) - Cell ( Cell ( , M / ) ) - , F / Zip city M / F / M / F / NOW, THEREFORE, in consideration of the premises an.

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