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 Ymca Intake 2013-2023

Ymca Intake 2013-2023

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Poster or flyer or event at the Y The Y s website LIVESTRONG Media TV web radio print etc. Other please specify LIVESTRONG at the YMCA Intake Form 5/2013 1 HEALTH INFORMATION 6. Date of birth DD/MM/YY. 2. Gender Male Female 3. Are you Hispanic Latino/a or Spanish origin One or more categories may be selected No not of Hispanic Latino/a or Spanish origin Yes Mexican Mexican American Chicano/a Yes Puerto Rican Yes Cuban Yes Another Hispanic Latino/a or Spanish origin 4. What is your race One or...
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