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LAST NAME FIRST NAME MIDDLE CONTACTS IN CASE OF EMERGENCY : (OTHER THAN PARENT OR GUARDIAN) ADDRESS 1. NAME PHONE RELATIONSHIP TO MINOR CITY/STATE ZIP.

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Who needs uprising application registrationpub read-only:

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Individuals who are interested in joining or participating in an uprising event or program.

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Organizations or groups that are hosting or organizing an uprising event or program and require participant registration.

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