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(May 17) Pro-D Day Camp Registration
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Email
*
Your email
Child's Name (First & Last)
*
Your answer
Child's Date of Birth
*
MM
/
DD
/
YYYY
Name of Parent/Guardian (First & Last)
*
Your answer
Mobile Number
*
Your answer
Any allergies or medical conditions we should know about?
*
Your answer
Child's Healthcare Number?
*
Your answer
Emergency Contact Name
*
Your answer
Emergency Contact Relation to Child
*
Your answer
Emergency Contact Mobile Number
*
Your answer
Anything else we should know about caring for your child?
Your answer
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