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2026 National Night Out Registration Form
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* Indicates required question
Name of Community or Business:
*
Your answer
Location of Event:
*
Your answer
Time of Event:
*
Your answer
Event Description (include activities):
Your answer
Anticipated Number of Participants:
Your answer
Barricades Needed to Block of Major Street?
*
yes
No
If yes, how many?
Your answer
Event Coordinator Name:
Your answer
Address of Coordinator:
Your answer
Phone Number:
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Email Address:
Your answer
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