Virtual POP Club
June 6- August 29 2020

*Please only submit one form per household*
For More Information: Ashlyn Wadsworth 704-862-5374 ashlyn.wadsworth@gastongov.com
Youth Name (s) (Please put first & last name) *
Youth Age(s) *
Parent/Guardian Email Address *
Mailing Address (will only be used to mail tokens or prizes) *must have an address on file to send prizes* *
Have you participated in POP Club in the past? *
Required
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