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COVID Vaccination Clinic Pre-Registration Form
Please complete this form if you intend for your BHS student to participate in the COVID vaccination clinic on May 14 and June 4.
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Email
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Your email
Name of Person Completing this Form:
*
Your answer
Best phone number to reach you:
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Your answer
First and Last Name of the BHS student:
*
Your answer
Additional BHS student to be vaccinated:
Your answer
Additional BHS student to be vaccinated:
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Optional: Use this space to ask a question or to provide any other information.
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