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Family Pumpkin Patch 10.22.22
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Name:
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Email address:
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Phone Number:
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Name the county you live in.
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How many family members (adults and children age 4 and above) will attend?
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How many children age 3 and under will attend?
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Name and age of 1st deaf/hh child:
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Name and age of a 2nd deaf/hh child:
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Name and age of 3rd deaf/hh child:
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