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2. Name*
4. Email*
6. Phone Number*
8. Name of Activity/Class/Camp*
10. Description*

    Please describe your program idea, including type of space and equipment needed

12. Age Range*
14. Proposed Dates & Time*

    Include days of the week, times, and length of program.

16. Cost of Program*

    What would be the anticipated cost per person?

18. Minimum & Maximum Participation *
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20. 1. Receive an email copy of this form.
21. Email address

    This field is not part of the form submission.

22. Submit

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