Derby Days Registration

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2026 Derby Days at the Mint Museum Randolph

First Name: Last Name: Email: Phone: Number of Attendees:

Include myself as an attendee:

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Waiver Statement:

I hereby grant the Young Affiliates of the Mint permission to use my likeness in a photograph, video, or other digital media (“photo”) in any and all of its publications, including web-based publications, without payment or other consideration.

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