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2015 Patriot Camp Registration Form

  Patriot Camp is scheduled from June 25-June 26

Student Last Name
Student First Name
Zip Code
Student Cell Phone Number
St. Catharine Email Address
Name of Emergency Contact (Parent/Guardian):
Phone Number of Emergency Contact (Parent/Guardian):
Do you have any Medical we should be aware of, Allergies, or Dietary Needs?
How did you hear about Patriot Camp? [Brochure, Registration Days, Website, Other]
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