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* 1. Would your child be interested in participating in a day camp for gender diverse and gender exploring 5-12 year olds?

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* 2. Which time would be possible for your child to attend the camp?

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* 3. Which of the following describes your situation? Select all that apply

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* 4. What would make camp attendance more likely for your family?

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* 5. If you selected Fall Break or Winter Break, please specify the dates.

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* 6. Your Name

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* 7. At what email address would you like to be contacted?

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