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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
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Group / Event Attendance (please indicate below)
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Thu, January 2 2025
2 Teves 5785
Thu, January 2 2025 2 Teves 5785
