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at ICNA Center | Sat. July 12, 3-5 PM
For Boys and Girls ages 5-12
2
Questions
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1
Parent and Child Information
Register up to 4 children per form
Parent Full Name
Phone Number
E-mail
Your Zipcode
Kid 1 Name/Age
Kid 2 Name/Age
Kid 3 Name/Age
Kid 4 Name/Age
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2
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I have read and fully understand the above waiver and release claim.
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