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ALPHA Registration

Please fill-out the form below to register for the Alpha program.

Name
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Phone --
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Email
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Mailing Address
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Preferred contact method
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Cell Phone Number for Texts --
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Age Range
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Dietary Restrictions/Allergies
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Do you need childcare during the Alpha course?
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How many children and what ages?
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example: two children ages 5 & 7
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