Base
| First Name | samantha |
| Last Name | blair |
| Age Range | |
| Address | 1700 3rd St. |
| State | TX |
| City | Wichita Falls |
| Phone Number | 940-642-2141 |
| Previously Participated? | |
| Company / Organization / School | Wichota Falls-Wichita County Public Health District |
| Describe Yourself | |
| Zip Code | 76301 |