CAMPS

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Summer Camp Application

First Name*
Last Name*
Gender*
Date Of Birth*
Ethnicity*
Attending*	In Person Online
Email Address*
Billing Address*
City*
State*
Zip Code*
Country*
Payment Amount*
Camp Type*
What school are you currently attending?*
College / Career Plan
Why do you want to attend the selected camp?
Emergency Contact Name*
Emergency Contact Number*
Alternate Emergency Contact Name
Alternate Emergency Contact Number
Payment Method*
Credit Card Number*
Expiration Date (MM/YY)*
Security Code*



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