2021 Camp Akalaka Registration

Are you ready for fun in the sun during the Summer of 2021?

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Email address *

Your email

Camper Name *

First & Last

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Age *

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Date of Birth

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DD

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YYYY

Gender

Female

Male

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Other:

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Street Address

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City

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State

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Zip Code

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Guardian #1 (Name and Relationship)

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Guardian #2 (Name and Relationship)

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Guardian #3 (Name and Relationship)

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Home Phone

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Day Phone

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Cell Phone

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Name of School and Grade Attending Sept 2020

Your answer

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