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Detroit Deltas E.M.B.O.D.I. Registration
Questions? Contact Us: EMBODI@detroitdeltas.org
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First and Last Name *
Email *
Mobile Number *
Name of student's school
Student's Grade *
Student's Age *
Event Name *
Location of Event *
Parent/Guardian Name *

Are you a member of DAC, Visitor or Guest?

Parent/Guardian Phone Number *
Mailing Address *
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