2020 Salam Academy Summer Camp Application
Email address *
Student Name *
Age *
Grade *
Parent Name *
Address *
Email Address *
Phone Number
Sessions *
I am interested in before/after care *
Required
Before Care/ After Care Packages *
Required
Student Food Allergies *
Medical Concerns *
Authorized Persons for pick up *
Emergency Contacts (Name and Phone #) *
A copy of your responses will be emailed to the address you provided.
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