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Only one registration per school is needed.

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Please register our school for the Born to be Free Connection.
All fields marked * are required to complete this registration.

School name:  *
School mailing address:  *
Suburb/Area:  *
Town/City:  *
Country:  *
(if other, please specify)  *
No. of classes involved:  *
Use numerals, estimate if unknown
No. of students participating:  *
Use numerals, estimate if unknown
Year(s) involved: * (primary)
  Year 1 = 5 years old
Where did you hear about this?  *

Contact: Our contact person for further communication is:
Contact name:
Position in school:
Phone:  *
Fax:  *
Email (1):  *
If you would like more than 1 person to receive email updates please enter additional email addresses.
Email (2):
Email (3):
Email (4):
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