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SUMMER 2024 REGISTRATION FORM

Your Name*

Student's Name* (If under 18 years old)*

Age of Student (If under 18 years old)

Email Address*

Home Phone Number

Cell Phone Number

Emergency Contact Information**

Health/Allergy Information*

Additional Information

Photo/Media Release*

CLASS SELECTION

WEEK #1
WEEK #2
WEEK #3
WEEK #4
WEEK #5
WEEK #6
WEEK #7
PAYMENT DETAILS

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