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Summer Discovery Registration Form

Please copy the list below into an email.
Fill in the required information for all 18 questions.
Email this information to Chriss at colare@comcast.net

1. Camper's Name:
2. Birthdate:
3. Age:
4. Female or Male:
5. School:
6. Grade 4, 5, 6, or 7 in the Fall?
7. Can you attend June 29 - July 3?
8. Has this student attended this camp before?
9. Has a sibling attended this camp before?

10. Parent's Name:
11. Parent's Address:
12. Home Phone:
13. Work or Cell Phone:

14. Emergency Contact Name:
15. Relation:
16. Home Phone:
17. Work or Cell Phone:

18. Does the participant have any health conditions/allergies we should be aware of? (Please type "none" if there are none.)