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Reachcya.org email reachcyainc aol.com Program Permission Form -must be completed by parent/guardian for youth to attend program Please print Youth Name Phone Address Grade School Date of Birth Parent/Guardian name Alt. Phone Emergency Contact Name EMAIL ADDRESS To notify you of program changes cancellations special offerings. I give my permission for to participate in the following program Drop In Basketball for HHH Middle School students Tuesday Nights October 18 2016 June 6 2016 6 00-7...
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