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YOUTH REGISTRATION FORM Please print unless otherwise indicated Event title and date: SUPERHEROES RALLY BATON ROUGE, May 2224, 2015 Name: Street Address: City: State: Zip Phones: hm cell Email: Birthday

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Please print unless oformrwise refers to filling out a form manually unless instructed otherwise.

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Any individual or entity who needs to submit the form must file please print unless oformrwise.

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Please print all required information neatly and clearly unless instructed otherwise on the form.

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The purpose of please print unless oformrwise is to ensure legibility and accuracy of the information provided on the form.

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All relevant information as requested on the form must be reported unless instructed otherwise.