Release of Liability form
First name *
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Last name *
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Phone # (Follow this pattern ###-###-####) *
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Emergency Contact Name *
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Emergency Contact phone number *
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Mailing Address *
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City *
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State *
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Zip Code *
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Email Address *
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Name of Group or organization (If applicable)
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Reason for visit *
What are the date(s) of your stay? *
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Names of family members at camp (Including Minor's) *
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Allergies *
Please list out any allergies for any names listed above.
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