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2. Name*
4. Boy or Girl*

   1. Boy
   2. Girl
5. Age*
6. Phone Number*
8. Address (for proof of residency)*
10. Brothers (Names & Ages)
11. Sisters (Names & Ages)
12. Pets (Names)
14. Presents received last year from Santa*
16. This year's wish list*
18. Check date of preference (we will try our best to accommodate)*

    1. Wednesday, December 13th
    2. Thursday, December 14th
19. Best Time (between 6 PM - 8 PM)*
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21. 1. Receive an email copy of this form.
22. Email address

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23. Submit

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