NERUSY's 5 Wits
January 27, 2019 1:30-5:00pm
Please provide the name of the person we should contact in the event of an emergency during this event
Emergency Contact Number
Please provide the number where the emergency contact can be reached during the event
Please describe any allergies or medical concerns that will impact the students participation during this event
I will submit payment of $30 at
I will submit payment of $30 to the Youth Box in Temple Israel's Main Office
I will pay $30 at the time of the event
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