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Rockaway Waterfront Alliance Youth Program Registration Form[removed]Season Check Applicable Programs Registering For : Shore Corps - Leadership Intern: Ages[removed]__) Cycle: Summer: ___ Fall:__ Spring: __
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Document Date: 2014-09-05 14:15:45

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IndustryTerm

public relations personnel / Media representatives / ground transportation / /

MedicalCondition

communicable disease / Allergies Hay Fever_____ Ivy Poisoning / Mumps / Ear Infections / Disease Chicken Pox / Measles / illness / German Measles / Chronic / Convulsion / serious injuries / Diabetes / Asthma / /

MedicalTreatment

first aid / /

Person

Ivy Poisoning / Trip Consent / John Cruz / /

Position

physician / Program Director / Rockaway Waterfront Alliance representative / surgeon / General / /

Product

Penicillin / /

ProvinceOrState

New / /

URL

www.rwalliance.org / /

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