WAITLIST-WyldLife Castaway 2018
Student Last Name *
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Student First Name *
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Student Phone
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Student Email
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Mailing Address *
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City *
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Zip *
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Gender *
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Current Grade (2017-2018 year) *
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Current School attending now
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T-shirt size
Parent /Guardian Last Name (s); First Names *
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Parent Email *
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Parent Cell phone
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NO payment is needed at this time. If a spot opens up, we will contact you and ask for the deposit at that time. Thank you!
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