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Please fill out and submit by February 1st, 2026
Full Name
Preferred name
Birthday (Must be 5-10 yrs.)
Month
Day
Year
Guardian's Phone
Guardian's Email
Address
Parents/Guardians Names
Siblings name(s), age(s)
Name of School
Favorite Subject
Hobbies/Interests
Brief Description of Irish Heritage
Parent/Guardian Signature
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