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* 1. Students's First Name

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* 2. Student's Last Name

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* 3. Parent/Guardian's Name

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* 4. Phone

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* 5. Email

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* 6. Please select the date of the tour you are registering for (all tour dates provided below are scheduled 10 a.m. - 1 p.m. at University Hospital):

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* 7. Please check the boxes to acknowledge the following:

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