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Youth Camp Registration Form 2017

August 6-10, 2017

Primary Caregiver Contact Information
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First Name
Last Name
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Camper Information
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First Name
Last Name

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(mm/dd/yyyy)
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If Yes, please let us know about accommodations in the IEP to help your child at school. You can also email the IEP to Julia@nwkidneykids.org or upload it here.

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(mm/dd/yyyy)
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