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Register A Hurricane Sandy Family 

One random recipient of grand gift basket will be chosen on July 27, 2013 at the Soulsational Festival. Chosen recipient must be present receive gift.  

Name of Nominator*

Email Address For Nominator*

Recipient of Gift - Family Last Name

Email Address To Contact Gift Recipient*

Phone Number to Contact*

Fist Names and Ages

Home Address At Time of Storm Sandy

Curret Living Address

Does the Family Have A FEMA Number*


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