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2. SIGN UP SHEET- MAY 10TH YAC

   Please fill out this form if you ARE PLANNING to come to our Young Adult Club event on Tuesday, May 10th.  It will be from 6:00 PM to 8:00 PM at the VLPRA main office located at 1901 North Barack Obama Blvd.  Please bring a 2-liter drink with you.

4. Participant First Name
5. Participant Last Name
7. Emergency Contact First Name
8. Emergency Contact Last Name
10. Emergency Contact Phone Number
12. Email Address
14. Food Allergies or other concerns?
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15. 1. Receive an email copy of this form.
16. Email address

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17. Submit

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