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JULY 10-14 from 6:30 to 8:30
AGES PK - 12th Grade
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Age and Last Grade Completed
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Parent/Guardian Name
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Email
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Address
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City, Zip
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Cell Phone
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Home Phone
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Emergency Contact Name and Phone (other than parent):
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Please list any diseases, physical, or mental conditions. (Asthma, Diabetes, Autism, Etc.)
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Van Pick Up Needed?
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