Grandparents Brunch - October 2021
Grandparent's First & Last Name
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Street Address
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Town/City
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State
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Zip Code
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I give Community Autism Resources permission to have myself, my family members, or any person(s) that I have registered for this Event to be photographed/videotaped for educational/publicity purposes only:
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Yes
No
I understand that participation in this event is at our own risk and will not hold Community Autism Resources liable for personal injury or loss/damage of personal property:
*
Yes
Email
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Telephone Number
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Grandchild/children with ASD First & Last Name
*
Grandchild/children's Age
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Name of Town/City your Grandchild/ children lives in
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# of people attending:
*
In this space, you can ask up to 2 questions for the Sibling Panel
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