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Name:
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Name of School, Church, Business, etc.
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When is your event?
MONTH
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DAY
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YEAR
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What time will your event START?
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6:00 am
7:00 am
8:00 am
9:00 am
10:00 am
11:00 am
12:00 pm
1:00 pm
2:00 pm
3:00 pm
4:00 pm
5:00 pm
6:00 pm
7:00 pm
other
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What time will you event END?
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7:00 am
8:00 am
9:00 am
10:00 am
11:00 am
12:00 pm
1:00 pm
2:00 pm
3:00 pm
4:00 pm
5:00 pm
6:00 pm
7:00 pm
other
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How many people are going to be at this event?
(This does not have to be exact)
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What is the Age range of the Participants? (I need to know the right age group
to make sure The material is age related.)
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Do any of the Participants have any Special Needs?
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Yes
No
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If YES, Please explain in full detail.
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If there is anything else that might be important for me to know. Please explain in detail below.
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Telephone Number: This is not required but strongly requested.
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Email Address: I will only use your email adress to contact you. It will not be viewable to anyone without your permission.
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