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All Aboard the Mystery Train
Please complete one form for each child
Date: July 18-21
Time: 5:30-7:30.
(Dinner included)
Address: 53555 Olive St
Contact us at
uccatlantic2@gmail.com
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Email
*
Your email
Untitled Title
Untitled Title
Address
*
Your answer
Child's Name
*
Your answer
Age
*
Your answer
Grade Completed as of June
*
Kindergarden
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
Preschool
Birthday
MM
/
DD
/
YYYY
Parent/Guardian Name
*
Your answer
Cell Phone Number
*
Your answer
Emergency Contact if different than guardian (name and number)
Your answer
Do we have permission to photograph your child and use it in online and printed promotional materials
*
Yes
No
Yes but I'd like my child's face blurred and no name used.
Food Allergies; please list (please put NA if none)
*
Your answer
Medical Concerns (please put NA if none)
*
Your answer
Permission to use bug spray and sunscreen?
*
Yes
No
Other:
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