92nd Street Y Trivia Challenge

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Child Information

Gender *:

First Parent/Guardian


Second Parent/Guardian


Additional Information

  Name Birthday School
Sibling 1
Sibling 2
Sibling 3
Does your child currently attend any 92Y programs? *:
Our play sessions are held on four dates. Please check the dates you are available.*:
I certify that the information supplied in this form is accurate to the best of my ability*:

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