| WEKT - Ham Broadcasting, Inc

Todd County Community Baby Shower

Your Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Your Email(Required)

Phone(Required)

Due Date or Birth Date of Infant(Required)

Bringing A Guest (1 per attendee)(Required)

Yes

No

If Yes, Name of Guest

First Last

List Any Food Allergies for Attendee and Guest Attending

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