REGISTRATION

Please fill out the below form. Upon completion we will send you an informational packet with a registration form, information on the program, and available dates.

Name:
Addess:
City:
State:
Zip Code:
Phone:
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Email:
Gender:	Male Female
Camp Session:	2009 Session 1 - June 14-June 20 2009 Session 2 - June 21-June 27
Date of Birth:
Parent or Guardian Name:
Parent's Phone: