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Individual SCIVIS Registration
Students who travel alone to camp or with a parent, friend, who is not staying for the week as a chaperone.
Student Name *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Age at time of camp *
Your answer
Grade at Time of Camp *
Your answer
Program Attending *
Parent Name *
Your answer
Email Address *
Your answer
Type Email again *
Your answer
Phone *
Your answer
City *
Your answer
State *
Your answer
Country *
Your answer
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