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Youth Camp Registration
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First Name
Last Name
Date of Birth
MM
/
DD
/
YYYY
Gender
Grade (Currently In)
Home Church
Youth Pastor/Leader Name
Emergency Contact Name
Emergency Contact Phone Number
Emergency Contact Email Address
T-Shirt Size
I give permission for the Florida District of the Wesleyan Church to take pictures of my child to be used in a newsletter, brochures or website promotional purposes
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