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* 1. Last Name

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* 2. First Name (please register your spouse on a separate registration)

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* 3. Email Address

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* 4. Home Campus

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* 5. I am a...

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* 6. Are you a vegetarian?

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* 7. Do you need childcare? (Children will receive breakfast in childcare)
Please register childcare on one form only, not on each parent's registration.

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* 8. Names of Children Needing Childcare

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* 9. Ages and Allergies of Children

  Age Allergies?
Child 1:
Child 2:
Child 3:
Child 4:
Child 5:

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