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

* 1. Participant Name

* 2. Type of Participant

* 3. Childcare Center Name

* 4. Type of Center

* 5. Address

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

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

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