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LifeTeen Camp 2021 Registration & Liability
The first email address (directly below) should be the parent/guardian's email address, and is where a copy of this form will be sent upon completion.
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* Indicates required question
Email
*
Your email
Participant Last Name
*
Your answer
Participant First Name
*
Your answer
School (attending Fall 2021)
*
Your answer
Grade (entering Fall 2021)
9th grade
10th grade
11th grade
12th grade
HS Grad/College
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Sex
*
Female
Male
Birth Date
*
MM
/
DD
/
YYYY
T-shirt Size (Adult Sizes)
*
S
M
L
XL
XXL
XXXL
Participant Email Address
Your answer
Home Address Line 1
*
Your answer
City, State & Zip Code
*
Your answer
Primary Phone Number
*
Your answer
Secondary Phone Number
Your answer
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