Children's Roundtable Registration Form

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* 1. Name

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* 2. Email

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* 3. Phone

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* 4. Do you follow any of the these dietary restrictions? (Please select all that apply.)

Vegan

Vegetarian

Religious Dietary Restrictions (e.g., Kosher, Halal)

Food Allergy (e.g. gluten free, peanut free)

Other (please specify)

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* 5. Do you have any accessibility requirements?

No

Yes (please specify)

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* 6. Will you need to bring any children to the roundtable?

No

Yes (please separate ages with a comma)