Value Academy Registration Form

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Value Academy Registration Form

Please fill out this form to register your teen in the Value Academy

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* Indicates required question

Email *

Your email

Child's Name *

Your answer

Birth Date *

MM

/

DD

/

YYYY

Address *

Your answer

Alternate Email Address

Your answer

Mobile Number *

Your answer

Alternate Number *

Your answer

School and Grade

Your answer

Shirt Size *

XS

S

M

L

XL

XXL

Other:

Food Allergies *

Your answer

Any other commitments besides the Value Academy *

Your answer

Emergency Contact Information *

Your answer

Send me a copy of my responses.

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