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BLAKK Juniors Program Sign Up Sheet
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Email
*
Your email
What is your child's full name?
*
Your answer
What's your child's age? (must be 12-18)
*
Your answer
What is your child's gender
*
Male
Female
What is your child's t-shirt size (adult sizes)
*
XS
S
M
L
XL
Other:
Does your child have any food allergies? If so list them here
*
Your answer
Does your child have a handicap? If so list them here
*
Your answer
Does your child have any health conditions? If so list them here
*
Your answer
Just in case of an emergency please list an emergency contact(at least two)
*
Your answer
Please list a good phone number and email so we can contact you further if needed
*
Your answer
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