RoughRiders Sports Club
Fire Support Form
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Email *
First Name
Last Name
Number of people in your household and age of children
Contact Phone Number
Home Address
Current Address (if different)
Impact of Fire
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Do you need shelter?
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Immediate Needs
Basic Essentials Needed - please be as specific as possible
Clothing Needs - please include sizes
Shoe Needs - please include sizes
School Needs
Sports Equipment needs
RoughRiders Sport Played
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