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LBPC Membership Renewal for 2009 -
$40 per family
 
 
Parent 1 Name :
     
Changes to contact info(address, phone, email, etc.) :
     
Are you expecting or did you have a baby in the last year?
Please help us keep our records current.
     
Child Name(or write "expecting") :
     
Gender :
     
Birthdate/Due Date :
     
Comments about the club (events you'd like to see in the future, positive/negative feedback, etc.):
:
     
Would you be interested in volunteering to be on the LBPC Steering Committee? :
YES
NO