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Summer Camp

Register:

First Name:

Last Name:

Emergency Contact:

Emergency Phone #:

Birthday:

E-Mail:

Phone #:

Street Address:

If YES explain:

Allergies:

Grade as of Sept:

Shirt Size:

City:

State:

State:

Zip Code:

Select Session(s) you are registering for:

Summer 1 (June 25 - June 28)

Summer 2 (July 9 - July 12)

Summer 3 (July 23 - July 26)

Summer 4 (July 30 - August 2)

Summer 5 (August 13 - August 16)

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