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Inspiring women

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Register for Girls Club

Please fill out and submit for each daughter who will be attending.

Daughter's First & Last Name

School

2022-23 grade

Date of birth

Mom's First & Last Name

Mom's Email

Mom's Phone Number

Emergency contact

Relevant information to share

Do we have your permission to use your daughter's photo in Wiggins House marketing material?

Thanks for registering! We look forward to seeing you in September!

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