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Middle School Mission Trip 2019
Wake Forest University (Winston-Salem, NC)
June 17-21
Cost- $319
Deposit- $70 due February 28
Student First Name *
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Student Last Name *
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Grade (2018-2019 School Year) *
Gender *
T-shirt Size (Adult Size) *
Name of Requested Roommate
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Parent Email *
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Student Email
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Parent Phone Number *
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Student Phone Number
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Food Allergies
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Medical Issues/Concerns
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