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ST. SARKIS SUMMER CAMP 2019
REGISTRATION FORM
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* Indicates required question
Email
*
Your email
Child's Last Name:
*
Your answer
Child's First Name
Your answer
Address:
*
Your answer
Date of Birth:
*
MM
/
DD
/
YYYY
Entering Grade in September 2019
*
Your answer
Father's Name:
*
Your answer
Father's Mobile:
*
Your answer
Mother's Name:
*
Your answer
Mother's Mobile:
*
Your answer
Mother's Email:
*
Your answer
Emergency Contact Name (Other than Parent):
*
Your answer
Emergency Contact Number:
*
Your answer
Relationship to Child:
*
Your answer
Please Check Off the Weeks you Wish to Register your Child:
*
July 08 - 12
July 15 - 19
July 08-19
Required
Any Allergies:
*
Your answer
Comments:
Your answer
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