Kuza Dada Camp Referral Form

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Thank you for your interest in Kuza Dada Camps!

Use this form to share the contact information for students who would like to participate, adults who would like to become facilitators, or organizations that would like to host a camp. We will do our best to respond to all referrals within one week.

Your Name *

Your Email *

Your Phone Number

Who would you like to refer? *

Camp Facilitator

Student

School or camp host

What is your relationship to the person or organization you are referring? *

If different from your own, please include the name and contact information for the person/organization you are referring.

Comments or questions

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