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* 1. Full Name 

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* 2. Email Address

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* 3. Phone Number

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* 4. What date during September do you think you will take part in Green Day?

Date

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* 5. Are you taking part with a school or company?

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* 6. If answered Yes above what is the name of the school/company?

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* 7. Would you like to sign up to our mailing list to receive up to date news from Legacy ?

T