EdVenture Camp Student Registration 2017
Student Name
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Current Grade
Parent/Guardian Name
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Phone Number- Home/Cell
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Email Address
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Work Phone Number
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Emergency Contact Name
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Emergency Contact Relationship
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Emergency Contact Phone Number
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Known Allergies
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Daily Medication
Name of Medication
Your answer
Transportation
Bus "pick up/drop off" address
Your answer
Permissions
Required
Signature
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Date
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DD
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