Form

Form
FCSO's Divine Nine Line Dance Health Challenge-2025

Savannah Region
Name

First NameLast Name
Are you an official D9 Chapter Member?
Official pledged member, financial status is not a factor
Fraternity - male greek letter org Sorority - female greek letter org
Are you an invited guest of an official D9 Chapter Member, 18 years of age and older?
If you are under the age of 18 you must have parental/guardian consent to participate.
I am the parent/guardian of an underage (under 18 years old) willing participant in FCSO's Divine Nine Line Dance Health Challenge. Do you give permission for this child to participate?
Email
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Address

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Date

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Date
Birth Date

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Date
Donation Amount

prevnext( X )
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FCSO's Divine Nine Line Dance Health Challenge-2025