2019 KENNEDY YMCA Storer Camps OEE Youth Health Form

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2019 KENNEDY YMCA Storer Camps OEE Youth Health Form

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* Indicates required question

Student's First Name *

Your answer

Student's Last Name *

Your answer

Student's Preferred Name

Only needed if different than First Name

Your answer

School *

Your answer

Date of Birth *

MM

/

DD

/

YYYY

Gender *

Male

Female

Other:

Student's Weight *

Your answer

Home Address *

Your answer

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