WACYPAA XXIII Pre-Registration
This is the first part in a two step process.

Please fill out the following questions and proceed to our square page at the end of this form.

Your registration will not be complete until you purchase it through our square store.

Email address *
Full Name *
Your answer
Sobriety Date
MM
/
DD
/
YYYY
YPAA Committee(State that you're from if none)
Your answer
Are you willing to be of service? *
Do you have any special needs?
Your answer
How many registrations do you want to purchase? *
Your answer
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