Team 4 ELEMENT Summer Camp Registrations
Student Full Name *
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Parent/Guardian Full Name *
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Parent/Guardian Email *
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Parent/Guardian Phone Number *
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Student Cell Phone Number
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Student Email
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Student Age
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Current School
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Current Grade Level
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Does the student have any allergies or medical conditions? *
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Digital Signature of Parent/Guardian *
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Any other information?
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Pay By: *
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