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Arts/Crafts Camp Registration Form

August 10-12, 2010          9am-Noon

Name______________________________________ Date of Birth__________________

Parent Name_____________________________________________________________

Address_________________________________________________________________

Phone Numbers___________________________________________________________

E-mail Address___________________________________________________________

Allergic To_______________________________________________________________

_________________________________________________________________________

Emergency Contact__________________________________________________________

Parents: Would you like to help chaperone? 

Tuesday _____, Wednesday _____, Thursday____