Art camp testing

First Name *
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Email *
Grade *
Birth Date *
Address *
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Zip Code *
Medical Information *

List Medications/Medical Conditions here. If none, type N/A

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Guardian First Name *
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Alternate Guardian First Name
Alternate Guardian Last Name
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Medical Release Information

Guardian Signature *

I, the parent/legal guardian, agree entirely to the Medical Release Information.: clear

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Demo 2 HS Art (C)

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$15.00

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CAMPER INFORMATION