Register - Kikaha O Ke Kai

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First Name

Last Name

Address

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Zip Code

Phone

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Mailing List

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Birthdate

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Second Adult First Name

Second Adult Last Name

Second Adult Birthdate

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Second Adult Email (optional)

Second Adult Cell Phone

Child 1 First Name

Child 1 Last Name

Child 1 Birthdate

(MM/DD/YYYY)

Child 2 First Name

Child 2 Last Name

Child 2 Birthdate

(MM/DD/YYYY)

Child 3 First Name

Child 3 Last Name

Child 3 Birthdate

(MM/DD/YYYY)

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