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August Summer Camp Registration Form
August Camp Registration Form
Student First name
*
Student Last name
*
Student Birthday
*
Month
Month
Day
Year
Food Allergies?
*
Parent 1 Full Name
*
Parent 1 Email
*
Parent 1 Phone
*
Parent 2 Full Name
*
Parent 2 Email
*
Parent 2 Phone
*
Country/Region
*
Address
*
Address - line 2
*
City
*
Zip / Postal code
*
Select one
*
Camp Counselor (Ages 12-16)
$300
Camper
$490
Signature
*
Clear
Date
*
Month
Month
Day
Year
Register & Pay
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