Boxing CAMP YOUTH AGENCY REGISTRATION
This registration is to secure your youth agencies our youth spot. An invoice will be sent after this form is submitted and must be paid by June 10th. If payment is not received, spots will be given to another youth agency on the waiting list. 
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Email Address *
NAME OF PERSON SUBMITTING FORM AND EMAIL *
NAME OF YOUTH AGENCY or Individual  *
NUMBER OF STUDENTS EXPECTED FROM YOUTH AGENCY *
NUMBER OF ADULTS ATTENDING THE CAMP TO SUPERVISE
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