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LTS Rhoer Roundup Registration Form
1
Parent Name
*
This field is required.
Please provide your name here
First Name
Last Name
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2
Child's Name
*
This field is required.
First Name
Last Name
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3
Child's Age
*
This field is required.
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4
Email
*
This field is required.
Please enter your email here.
example@example.com
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5
Phone number
*
This field is required.
Please enter your phone number (will only be used if designated)
Please enter a valid phone number.
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6
Preferred contact method?
*
This field is required.
What is your preferred method of contact?
Please Select
Email
Text
Either
Please Select
Please Select
Email
Text
Either
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7
Do we have permission to contact you at your preferred method to provide information regarding Rhoer membership?
Please select one option
YES
NO
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8
Do you have more than one girl to sign up?
*
This field is required.
Please select one option
YES
NO
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9
If you answered yes to the above question, please list their names and ages below.
Enter First and Last Name and their age below
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