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* 1. First and Last Name

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* 2. Will your children be participating in the summer meal program that will be providing breakfast and lunch to children ages 1-18?

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* 3. The summer lunch program is open for children ages 1-18. How many children from your household will be participating in the program this summer? This program will provide breakfast and lunch to the children.

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* 4. What location will your children be participating in?

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* 5. We are also needing volunteers to help with the program. If you would like to volunteer please provide your name and contact information.

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