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1-888-Life-EMS (543-3367)
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Camp 911
  1. Campers Name(*)
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  2. Camper's Age(*)
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  3. Camp Dates (*)
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  4. Please indicate any health concerns or special needs. We try to accommodate requests. However, should your child need one to one attention, we may require you to provide it.
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  5. Parent/Guardian Name(*)
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  6. E-mail(*)
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  7. Phone (*)
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  8. Address(*)
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  9. City(*)
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  10. State(*)
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  11. Zip Code(*)
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