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Emergency Camp 3/30 - 4/3
Non-members $23 per day/Members $19 per day
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Child's Name (one per form)
*
Your answer
Primary Email Address
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Your answer
Child's Grade Level
*
Kindergarten
First Grade
Second Grade
Third Grade
Fourth Grade
Fifth Grade
School Your Child Attends
*
AL Lotts Elementary
Ball Camp Elementary
Bearden Elementary
Beaumont Magnet Elementary
Bluegrass Elementary
Cedar Bluff Elementary
Farragut Intermediate School
Green Magnet School
Halls Elementary
Hardin Valley Elementary
Northshore Elementary
Pleasant Ridge Elementary
Rocky Hill Elementary
Sarah Moore Green Elementary
Shannondale Elementary
Spring Hill Elementary
West Hills Elementary
Other:
Camp Location Attending
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Cansler YMCA
Northside YMCA
West Towne Christian Church
West Side YMCA
Do You Have EFT? If NO payment due on arrival
*
Yes
No
Will Your Child Need Medication at Camp?
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Yes
No
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