*Please note that this event has limited spaces. Only those registered will be able to attend*

**Personal information used is for the sole purpose of registration. Your information will not be shared outside of Central Alberta FASD Network unless written consent is provided.

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* 1. Information

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* 3. Phone

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* 4. How many attendees are joining you? Please list below.

If it is just yourself please respond with - "1"

If you are registering for others - please respond with the number of attendees and their names.

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* 5. Please confirm all of your information is correct.

If you need to contact us to change a registration or any other inquiries - please email kharlow@fasdca.ca

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