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Hawthorne Community Day Camp
Email address *
Child's Name (Last Name, First Name)
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Mobile Phone Number
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Street Address
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City, State, Zip
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Grade Level Completed
Child's Age
Child T-shirt Size
Parent/Guardian Name (Last Name, First Name)
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Emergency Contact Person
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Emergency Contact Person Phone Number
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Please list any medical concerns, allergies or any other important issues we should know about your child:
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