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Great Blue Heron Community School Interest
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Name of guardian responsible for the child(ren)
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Your answer
Name of child(ren)
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Your answer
Guardian's email address
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Your answer
Child's Age (Birthdate would be most helpful)
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Your answer
Child's Gender
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Does the child know anyone involved with Blue Heron? If yes, who? Especially let us know if they are hoping to be at the program with a particular person(s).
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Please rate your day & location preferences for THIS youth's attendance
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I wish to attend this option if space is available
This isn't my preferred option, but I would register if my 1st choice isn't available
I am uninterested in this option
Attending Thursdays in Dummerston
Attending Tuesdays in Putney
Attending Wednesdays in Guilford (Under Development)
I wish to attend this option if space is available
This isn't my preferred option, but I would register if my 1st choice isn't available
I am uninterested in this option
Attending Thursdays in Dummerston
Attending Tuesdays in Putney
Attending Wednesdays in Guilford (Under Development)
Anything else you want to let us know? Or are there any specific questions you have?
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