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LUK Family Center Event Registration Form
Please complete a new form for each registered individual
OK
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1.
Select from the dropdown list the event you are registering for:
(If you are not seeing the event listed, capacity has been reached for registration)
(Required.)
Please Select a Response
Decades of Disabilities: A Family's Journey on Wednesday, September 17th, 6:00 PM - 8:00 PM via ZOOM
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2.
Full Name:
(Required.)
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3.
Whom are you registering?
(Required.)
Youth (0-17)
Adult (18+)
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4.
What is your E-Mail Address?
(Required.)
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5.
What is your phone number? (The best number to reach you)
(Required.)
6.
(If Applicable) Please let us know the name of your LUK Worker:
Current Progress,
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