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I am prepared to commit to Declare Emergency Campaign actions knowing there is a possibility that it could lead to my arrest * Yes No Not sure
I am available to participate in actions in Washington DC for one or more days in the future. * Yes No Not sure
If I attend a Declare Emergency campaign action, I will conduct myself in strict nonviolent discipline towards participants, the public and the police. * Yes I will.
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Completing this will help organizers plan for upcoming nonviolent civil resistance actions in Washington DC. Thank you for your sacrifice and support! We will be in touch!

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