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Awakenings 2018 Fall Registration
First Name *
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Last Name *
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Email Address *
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Cell Phone # *
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Street Address *
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City *
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Zip Code *
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Which Awakenings do you plan to attend? *
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Age Range (Optional but VERY helpful as groups are arranged)
Are there any specific women with whom you would like to be placed in a small group?
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If are you new to Awakenings, are you open to a multigenerational group?
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Will you need childcare? If so, please list the names and ages of your children.
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