Basketball Photo Registration Form
Full Name Of Participant
*
Email of Partipant, Guardian or Caregiver
Phone of Partipant, Guardian or Caregiver
Phone Number of Guardian or Caregiver
Ethnicity of Participant
African American
American Indian or Alaska Native
Asian
Hispanic or Latino
Multiethnic
Pacific Islander
White
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Primary Language
Diagnosis of Participant
Age of Participant
Preferred Photo Date (Not guaranteed)
Feb. 11th
Feb. 25th
Would you like to receive Emails from CGS?
*
Yes, I want to receive Emails from Common Ground Society.
No
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