Copy of page: Registration ( $10 FEE per participant)

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* 1. Participant Name

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* 2. Type of Participant

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* 3. Childcare Center Name

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* 4. Type of Center

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* 5. Address

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* 6. Fee: $10 (includes a boxed lunch from Zaxbys). Training funded by DHR. Water will be provided. Lunch options include:

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* 7. I will pay by the following by April 25:

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