Summer Camp 2020 @ East Cloud Kungfu
Please fill out the form for each child that will attend in order to register for our summer camp program.
Email address *
Student Name *
Your answer
Student Birthdate *
MM
/
DD
/
YYYY
Parent Name *
Your answer
Parent Phone Number *
Your answer
Emergency Contact Name (must be someone other than already named parent) *
Your answer
Emergency Contact Number *
Your answer
Relationship to Student *
Your answer
Names of all those authorized to pick-up your child *
Your answer
Any other important information about the student that we should know about before they attend our camp, medical or otherwise? *
Your answer
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