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Email* Camper First Name* Camper Last Name* Date of Birth* Main Parent Email* Parent or Emergency Cell Phone Number* Father Name (First & Last)* Mother Name (First & Last)* Home Street Address* City* State* Zip Code* How did you hear about camp?* Please indicate any health factors (including dietary restrictions) that staff members should be aware of. Do you have anything else you want to mention? Read the waiver and release Please sign your name (Parent/Guardian)*