ASNAP

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Join A-SNAP, Inc.

Fill out the following and email or see the instructions at the bottom.

PARTICIPANT:
Name:

Birthdate: (mm/dd/yyyy - optional for calendar)

Email:

Street: City ZIP:

Telephone: Home (xxx-xxx-xxxx) Cell (xxx-xxx-xxxx)

RESPONSIBLE PERSON   (PARENT(S)/GUARDIAN(S)/PERSON FROM GROUP):

      Name(s):   

Email:

Street: City ZIP:

Telephone: Home (xxx-xxx-xxxx) Cell (xxx-xxx-xxxx)

 

FOR PUBLICITY RELEASE

A-SNAP has my permission to photograph the participant during A-SNAP activities

A-SNAP has my permission to identify the participant in the photos

Name: (mm/dd/yyyy)

Responsible Person Signature and  Date

PARTICIPATION FEE to be determined by the Board of Directors.

If no email, print Join Document and Mail

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