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2023 TCOJC Youth Camp Registration
If submitted, this form will replace your paper registration. Please contact us if you have any questions or problems with the form. We may be reached at (219) 928-3357.
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Email
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Your email
Primary Applicant Information
If this application is for one person only, please provide your information. If this application will be used for a family, please list information for the Head of Household.
Primary Applicant Name (Head of Household)
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Primary Applicant DOB
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Please give the date of birth for the person listed above.
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Address
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Please include street address, city, state, and zipcode.
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Phone Number
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List any numbers that we may contact you at.
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