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SHOMREI EMUNAH YOUTH SURVEY
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Child's Last Name
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Child's First Name
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Date of Birth
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What grade is your child in or going into?
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Street Address
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City/State/Zip
Child's Email
Parent's Email
Allergies
Group / Event Attendance (please indicate below)
Does not attend any events
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Sun, February 2 2025
4 Shevat 5785
Sun, February 2 2025 4 Shevat 5785
