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BKCC Back to School Extravaganza
STUDENT REGISTRATION FORM
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Student's First Name
*
Your answer
Student's Last Name
*
Your answer
Student's Age
*
Your answer
Name of School Attending 2021-2022
*
Your answer
Please select the type of school attending.
*
Pre-K
Elementary
Middle /Jr. High
High / Senior High School
Home School
Charter School
Other:
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E-mail Address
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Phone Number
Please enter Area Code and number with no hyphens. EX:4695558888
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Phone Type
Home
Mobile
Home Address
*
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