Rochester Camps - Boys & Girls Health Form
This Form is to be completed by a parent or guardian. You may need to contact your doctor for information, but you are NOT required to have a doctor fill out the form itself. Every section must be filled in completely. Please write N/A if not applicable.
Participant Information
First Name *
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Last Name *
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Date of Birth *
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Gender *
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Primary Phone *
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Type
Mobile, home, work, etc.
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Secondary Phone
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Type
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Email *
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Address
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City
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State
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Zip
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Country
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Province
Canadian Residents Only
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Postcode
Canadian Residents Only
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