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Teen Talk Summer Series Registration Form
Participant First & Last Name
*
Participant D.O.B.
*
Name of Parent/Legal Guardian
*
Phone Number of Parent/Legal Guardian
*
Home Address
*
Emergency Contact First and Last Name
*
Emergency Contact Phone Number
*
Participants T-Shirt Size (Adult Size)
*
Do you have reliable transportation?
*
Yes
No
Does your teen have comfortable attire to wear?
*
Yes
No
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