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Spring Break Camp Registration

PARENT/GUARDIAN INFORMATION

EMERGENCY CONTACT (Please list an alternate emergency contact in case we cannot contact the listed parent.

MEDICAL INFORMATION

ALTERNATE PICKUP

(Please list 2 people who have your permission to pick up your child in the event that you are unable to. Please let these people know that they will need to present photo ID to pick up your child.

Alternate Pick-up #1

Alternate Pick-up #2

CAMPER INFORMATION

Birthday
Kids Farm Camp Dates
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