GENERAL STUDENT INFORMATION:

This application must be completed in the presence of an adult.
To be considered for the camp, ALL fields must be completed.
Your application and adult references are due Saturday, May 1.

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* 1. Name and relationship of adult who was present when completing application:

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* 2. Participant Name:

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* 3. Home Address:

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* 4. Mailing address (if different from home address):

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* 5. City/State/Zip:

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* 6. Phone Number:

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* 7. Email:

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