First name *
Last name *
Phone *
Email address *
Child 1 Name *
Child 1 Age *
Child 2 Name (optional)
Child 2 Age (optional)
Child 3 Name (optional)
Child 3 Age (optional)
Child 4 Name (optional)
Child 4 Age (optional)
Child 5 Name (optional)
Child 5 Age (optional)
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Account name: The Baby Lounge Limited. Account Number – 0253095441 Bank: GTBANK
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