Register : BASIC Holiday Celebration Jan 2015
Please contact us for question at andreaj@basicsupport.org or Direct all calls to:(570) 664-0651

We will provide a snack and refreshments. So,we never turn any children away from our events. Please bring a dish or snack. We depend on your dish or snack donations to supplement what we have. Thank you Please don't hesitate to call with any questions.

Name
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Age
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Parent /Gaurdians Name
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School Name
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Special Needss (food etc.)
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Dishe or Snack
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Would you like to become a BASIC member? *
Do you know how to ride a horse?
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Do you want to learn to ride a horse?
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Contact Information
Phone Number
Email
Address
Email
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Phone#
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Address
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