JULY 9th-13th    Cost: $125                          **PLEASE MAKE SURE TO CLICK THROUGH ALL THREE PAGES AND SUBMIT PAYMENT PAGE--IF NOT, YOUR FORM WILL NOT BE RECIEVED.                                        
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Email *
Student's FIRST and LAST Name *
Biological Gender *
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Address *
City  *
School *
Grade  *
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Parent/Guardian Name *
Parent/Guardian Phone Number *
Emergency Contact Name (please put a different name than Parent/Guardian) *
Emergency Contact Phone Number *
Please list all medication the participant is currently taking:
Please list all allergies the participant has:
Please list any medical or other conditions we should be aware of: 
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