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EMC Arts Movie Night Registration
Parent/Guardian First Name (if applicable)
*
Parent/Guardian Last Name (if applicable)
Email
*
Phone
*
Child's Full Name
*
Child's Age
*
Address
*
Do your child have any allerges that we need to be aware of?
*
Emmergency Phone Number
*
Payment option:
$35 per child
$20 for additional sibling
Submit
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