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2026 Spooktacular at LuskinOIC
First Name
*
Last Name
*
Email
*
example@example.com
Cell Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Have you received services at LuskinOIC before?
*
Yes
No
How did you hear about this event?
*
Flyer
Social Media
LuskinOIC Email
LuskinOIC Staff
Other
Other - Please specify
Are you bringing any children under 18 years old?
*
Yes
No
Minor Media Release (Please Read)
*
I am the parent or legal guardian of the minor(s) listed below, and I consent to Luskin Orthopaedic Institute for Children photographing/filming them at this event and using their image, likeness, and voice in Luskin marketing and promotional materials (including social media, websites, print, and press) without additional notice or compensation. I understand this does not permit photography in clinical areas and that I may request a No-Photo wristband at check-in to withdraw consent for today’s event.
Minor Children - Add each child in the household that is present
*
Parent/Guardian Signature
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Date
*
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Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
RSVP Status
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