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Registration Information

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Child/Counselor Attending (If applicable, please put "counselor" beside name

Child Attending (Counselor may put zero

If applicable, please list above. *Medical note required.

Billing Details

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This information must match the address on file with your bank or credit card.

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Must be 10 digits, ex: 555-555-5555
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Payment Details

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This should be 3 or 4 digits
This should be a 9 digits
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Total payment: $0.00