COVID-19 Cancellation Form

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* 1. Please provide us with your contact information

Name

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 2. Please provide the name of your registered camper.

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* 3. Registered Program Type:

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* 4. Session Dates:

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* 5. Is your camper registered with a Pioneer Group? (Did you register your camper through your church?)

Yes

No