Survey for Child Care Requirements for Meet the Candidates Night

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* 1. What is your first and last name?

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* 2. What is your email address to confirm your request for child care?

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* 3. What is your cell phone for contact on the night of the event?

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* 4. How many children will you be registering for child care on October 29th at 7:30pm?

1

2

3

4

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* 5. Please list each age and name of child attending

Child 1

Child 2

Child 3

Child 4