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FabNewport Summer Camp 2020 Registration
Email address *
Name *
Your answer
Age *
Your answer
Gender *
Birth Date
MM
/
DD
/
YYYY
What race or ethnicity is your child? *
Your answer
Any special interest in this camp?
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Select the week you'd like to participate in
Grade *
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School *
Your answer
Allergies *
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Other medical information
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Street/Neighborhood *
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City/Town *
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State *
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Zip *
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Parent/Guardian Name *
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Parent/Guardian Phone
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Parent Guardian Email
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Other Parent Guardian
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Other Guardian's Phone:
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Child's Insurance Information:
Your answer
Does your child receive free or reduced lunch? *
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