Milford Mill Band Camp Registration
First Name *
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Middle Name *
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Last Name *
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Home Address *
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City *
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Zip Code *
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Cell Number *
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Primary Email Address *
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Secondary Email address *
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Gender *
School you now attend? *
What is your primary instrument? *
Parent First Name *
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Parent Last Name *
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Parent email *
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Parent cell# *
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Comments
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Please list below an emergency contact in the event a parent/guardian cannot be reached:
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Phone# *
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