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Community Workshop Registration

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Contact Information
Contact Name: *
Email:*
Address:*
City:*
State:*
Zip:*
Phone: *
Emergency Phone:
Group Name: (if group)
Attendee Name and age: (if individual)
   
Details:
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Comments or Special Instructions:

Photo Release:* By registering for this program I give JGR Group, LLC permission to publish in print or video format the likeness of myself / my group. I release all claims against the JGR Group, LLC with respect to copyright ownership and publication including any claim for compensation related to the use of the materials.
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