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SPECIAL ACCESS

REGISTRATION

First Name

Last Name

Email

Phone

Street Address

Postal / Zip code

City

MAXIMUM 4 TOYS PER HOUSEHOLD

NUMBER OF KIDS | MAX 4

NAME OF SCHOOL

LIST EACH CHILD'S NAME, AGE & GENDER BELOW

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The Julian Jumpin Perez Foundation Chicago, IL 60651

©2022 Julian Jumpin Perez Foundation. All rights reserved.

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