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Cheer Camp 26
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Camp Fee
$270.00
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Participant's First Name
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Participant's Last Name
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Allergies
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Any medical history we should know
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Do we have your permission to take your child to the nearest doctor or hospital should in our opinion the situation warrant this action?
Yes
No
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The Doctor on call, or Doctor contacted, has my full permission to treat or render emergency care.
Yes
No
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Who is your family doctor?
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In case of an emergency, where may we reach him/her?
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Please list name and phone number of nearest responsible party.
Please give two contacts
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