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* 1. Name:

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* 2. Address:

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* 3. Email address:

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* 4. Phone:

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* 5. School:

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* 6. Grade:

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* 7. In case of emergency:

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* 8. Do you have any dietary restrictions? Or allergies?

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* 9. In 100 words or less tell us why you'd like to participate in this workshop or are interested in playwriting.

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