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Real Life Kids Registration Form
Real Life Kids Registration Form
ws_admin
2020-04-14T19:54:48+00:00
Please enable JavaScript in your browser to complete this form.
Parent/Guardian Name (1)
*
First
Last
Parent/Guardian Name (2)
First
Last
Cell Phone (1)
*
Cell Phone (2)
Email
*
Address
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
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Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
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Nebraska
Nevada
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New York
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Oregon
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Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Permission to use pictures/videos for RLC promotions?
*
Yes
No
How many children are you registering?
*
Please choose
1
2
3
4
5
Please fill out their information below once selection is made.
Child's First & Last name
First
Last
Date of Birth
Grade
Gender
Male
Female
Allergies/Special Needs
Child's First & Last name (2)
First
Last
Date of Birth (2)
Grade (2)
Gender (2)
Male
Female
Allergies/Special Needs (2)
Child's First & Last name (3)
First
Last
Date of Birth (3)
Grade (3)
Gender (3)
Male
Female
Allergies/Special Needs (3)
Child's First & Last name (4)
First
Last
Date of Birth (4)
Grade (4)
Gender (4)
Male
Female
Allergies/Special Needs (4)
Child's First & Last name (5)
First
Last
Date of Birth (5)
Grade (5)
Gender (5)
Male
Female
Allergies/Special Needs (5)
Phone
Submit
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