Summer Camp Registration

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Summer Camp Registration

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* Indicates required question

Camper's First and Last Name *

Your answer

Date of Birth *

MM

/

DD

/

YYYY

School *

Your answer

Phone Number *

Your answer

Gift and Talent *

Your answer

Please list any allergies *

If no allergies, enter N/A

Your answer

Parent First and Last Name *

Your answer

Street Address

Your answer

City *

Your answer

State *

Your answer

Zip Code *

Your answer

Email Address

Your answer

Contact Number *

Your answer

Relationship to child *

Your answer

Parent 2 First and Last Name

Your answer

Email Address

Your answer

Contact Number

Your answer

Relationship to Child

Your answer

Submit

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