Gulfport UMC Registration Form
June 24 - 28, 2019
Camper Full Name (called) *
Your answer
Gender *
Address *
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City, State, Zip Code *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Current Grade *
Parent Name *
Your answer
Parent Email Address *
Your answer
Parent Cell Phone *
Your answer
Parent Work Phone *
Your answer
Alternate Emergency Phone *
Your answer
Any special dietary/allergy needs? If so, please explain. *
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