Catalyst Challenge Camp Registration Form

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Please complete one of these forms for EACH CHILD that you would like to register for our Summer 2021 Programs.

Email *

Parent Name *

Parent Phone Number *

Emergency Contact: (Name and Phone Number) *

Students' First and Last Name *

Upcoming Grade *

Does your student have any Special Needs? (Allergies, 504 Plan, IEP) *

Which Session will your child be attending for our Summer Workshops? *

Session 2: July 12th- July 29th

Only our morning session from 8:00 AM- 12:00 PM is currently available. Do you agree to this time? *

Yes

I consent to my child being photographed during Workshop Activities by an approved Momentum Employee for marketing purposes. *

Yes

Send me a copy of my responses.

Submit

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