Please complete the form below to register for the 2026 RAYSAC Prevention Roundtable being held September 25, 2026 at the Greenfield Education Center, located at 57 S Center Drive in Daleville, Va.

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1. Attendee's Name (Required.)

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2. Attendee's Email (Required.)

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3. Attendee's Phone Number (Please Note Cell or Office w/ Ext.) (Required.)

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4. Organizational Affiliation (If None, Please Enter "N/A") (Required.)

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