Registrant Information
Child First Name: *
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Child Last Name: *
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Age *
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Enrolled School - Fall 2018 *
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Grade - Fall 2018 *
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Gender - Choose from list *
Shirt Size *
Preferred Contact Email - johndoe@yahoo.com *
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Parent 1 Name - First *
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Parent 1 Name - Last *
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Parent 1 Cell Phone - 888-123-4567
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Parent 2 Name - First
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Parent 2 Name - Last
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Parent 2 Cell Phone - 888-123-4567
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How did you hear about us?
Choose Camp Site *
Summer Break 2018 (Half Day 9 am - 12 pm $55) (Full Day 8 am - 5 pm $105) (Extended Hours 7:30 am - 6 pm $120) *
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Emergency Contact Name *
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Emergency Contact Number - 888-123-4567 *
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Does your child have any medical conditions? Please Explain *
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Please read carefully: *
I hereby authorize the directors of the Desert Reign Sports and Nutrition Camp to act for me according to their best judgment in any emergency requiring medical attention and I hereby release, exonerate and discharge Desert Reign, Inc, Desert Reign Foundation, the camp and its employees from any and all actions or cause of actions known or unknown for any injuries incurred while at camp or on the way to camp. I hereby authorize Desert Reign to photograph or film my child/children at the Desert Reign Sports and Nutrition Camp and this maybe used for promotional material.
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