January 9th Ferney Ramirez Registration
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First Name *
Last Name *
Email address
Phone number
What grade is/are your child(ren) in? *
Required
Do you have a child who is identified as an English Language Learner? *
Will you need childcare for this workshop? *
If childcare is requested, please list the first name and age of each child: 
Do you have any additional questions?
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