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Attendee Information
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First Name
Last Name
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Example: 2019

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Emergency Contact Information
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First Name
Last Name

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Payment/Miscellaneous Information
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The total cost of the trip is $75. An initial $25 deposit is required by February 10, 2019. A second deposit of $25 is required by March 3, 2019. Please pay the remaining $25 by March 10, 2019. Email Sr. Leandra (lkosmoski@ur.rochester.edu) if you have any questions or require a scholarship.