Adventure Club 2025

Childs Information

Name

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Phone

*

Age

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Grade

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Address

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Allergies

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Parent Information

Parent Name

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Parent Phone

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Email

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This address will receive a confirmation email

Parent Name

Parent Phone

Parent Email

Who may pick up my child?

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Emergency Contact Information

Emergency Contact Name

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Emergency Contact Phone

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Emergency Contact #2 Name

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Emergency Contact #2 Phone

*

Description

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