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MLC Recruitment Trip (November 24-27, 2019)
An opportunity for high school students to tour and experience campus life and ministry at Martin Luther College
Attendee's Last Name *
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Attendee's First Name *
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Home Address *
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Attendee's Phone Number *
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Attendee's E-mail Address *
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Attendee's Grade *
Attendee's Gender *
Parent / Guardian's Name *
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Parent / Guardian's Phone Number *
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Parent / Guardian's E-mail Address *
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Is a parent / guarding attending this trip? *
Health Insurance Company *
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Policy Number *
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Name on Policy *
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Does this attendee have any allergies or medical conditions? *
If YES, please specify.
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PERMISSION TO TREAT IN AN EMERGENCY: In the event of an emergency, I understand that every effort will be made to contact me. I give permission for my child to be treated at the nearest hospital or medical facility at the discretion of chaperones. I agree to pay any costs that are incurred and will not hold the camp sponsor or camp staff liable for the cost of any health care provided to my child. (Please type full name.) *
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Date Signed *
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Airline and Flight # of Arriving Flight (11/24/19) - try to arrive by 7 PM
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Airline and Flight # of Departing Flight (11/27/19)
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