JCA Teen Social Justice DC Trip
Student Name
First Name
Last Name
Student Grade Fall 2024
9
10
11
12
Parent Name
First Name
Last Name
Parent Email
example@example.com
Parent Phone
Please enter a valid phone number.
Parent Signature - We are committing to participate in the JCA Teen Social Justice DC Trip January 31-February 3. The $50 deposit is non-refundable unless the JCA cancels the trip for any reason.
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Teen Trip Deposit
$
50.00
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
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