Milton Wide Alpha Retreat
February 23-25 2018 / Fair Glen, Beaverton, ON.
Student's Name *
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Student's Birthdate *
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Student's Grade *
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Student's Gender *
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Parent or Guardian's Names *
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Parent's Email
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Parent or Guardian's Home Phone Number *
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Parent or Guardian's Cell Phone Number *
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Family Doctor's Name *
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Family Doctor's Number *
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Student's Health Card Number *
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Emergency Contact Name (If guardian cannot be reached). *
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Emergency Contact Number *
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Does your student have any allergies or illnesses we should be aware of? If so, what are they? Please include any serious food intolerances.
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Does your student take any medications? If so, will they need help administering it over the course of February 23-25. Please include details.
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Is there a friend your student would like to room with? We will try our best to accommodate.
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LAST YEAR'S RETREAT!
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