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BCAL-3731 Rev. 7-12 Previous editions 9-09 3-08 10-07 1-06 may be used until 12/31/13. See Reverse Side Emergency Contact Release of Child List all individuals including parents/legal guardians in order of preference to be contacted in an emergency. CHILD INFORMATION RECORD State of Michigan Department of Human Services - Bureau of Children and Adult Licensing Instructions Unless otherwise indicated all requested information must be provided. If .

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