I AM THE BEAR SIGNUP

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First Name*

Last Name*

Email Address*

Your Email Address is required. If you forgot your User Name or Password, it will be emailed to the address you provide here.

User Name*

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Password*

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Street Address*

Your I AM THE BEAR card will be mailed to this address.

Apt. #

City*

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Zip Code*

Date of Birth*

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Home Phone

() - Unlisted

Marital Status

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Cell Phone

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* Depending on your cell provider service plan you may be charged for incoming text messages.

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