2012 Camper Information Form
 

1. Camper Information Form

 
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The information on this form is gathered to assist us in identifying appropriate care. Please submit this form two weeks prior to campers attendance at camp.
This form must be completed and submitted to our office two weeks prior to your child's attendance at Camp Miller. All information will be confidential and used to best meet the individual needs of your child.

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1. Camper's Last Name, First Name, Middle

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2. Date of Birth

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3. Gender