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Teens Speak for Parents
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* Indicates required question
Email
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Your email
First Name | Primer Nombre
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Your answer
Last Name | Apellido
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Your answer
Phone Number | Número de Teléfono
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Your answer
Street Address |
Dirección
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Your answer
City | Ciudad
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Your answer
State | Estado
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Your answer
Zip Code | Código Postal
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Your answer
Which conference will you attend? | ¿A qué conferencia asistirá?
English Session - April 18th from 3:00PM to 6:00PM
Espanol - Abril 25 de 3:00PM a 6:00PM
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How many adults will be participating in this event with you, including yourself? | ¿Cuántos adultos participarán en este evento contigo, incluyendo usted misma?
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1
2
3
4
5
Other:
Do any of your children attend School #6? | ¿Alguno de sus hijos asisten a la Escuela #6?
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Yes | Si
No | No
If "yes", Please list the full name of child(ren) |
En caso afirmativo, indique el nombre completo de los niños
Your answer
If you will attend this event with your children, please indicate how many children you will bring with you. | Si asistirá a este evento con sus hijos, indique cuántos niños traerá con usted.
Your answer
If you will attend this event with your children, please indicate which grade your children are currently in. | Si asistirá a este evento con sus hijos, indique en qué grado se encuentran actualmente sus hijos.
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Daycare Age (0-2 years old)
Pre-K through K (3-5 years old)
1st Grade - 3rd Grade (6-8 years old)
4th Grade - 6th Grade (9-11 years old)
I will not take any children to the conference | No llevaré ningún niño/a a la conferencia
Other:
I, (PRINT NAME), grant permission to New Destiny Family Success Center and its staff the irrevocable and unrestricted right to reproduce the photographs and/or video images taken of me, or members of my family, for the purpose of publication, promotion.
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Yo, (NOMBRE EN IMPRENTA), otorgo permiso a New Destiny Family Success Center y a su personal el derecho irrevocable y sin restricciones de reproducir las fotografías y/o imágenes de video tomadas de mí o de miembros de mi familia, con fines de publicación o promoción.
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