Prevention Programs Presents: Mental Health Youth Basketball Camp with RaeAnn West and Lakota Beatty
Location: Calumet High School Gym
Dates:
December 7th & 8th 2024
Parent/Guardian Name:
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First Name
Last Name
Parent/Guardian Phone Number:
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-
Area Code
Phone Number
Parent/Guardian Email:
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example@example.com
Emergency Contact Name:
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First Name
Last Name
Emergency Contact Phone Number:
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-
Area Code
Phone Number
Participant Name:
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First Name
Last Name
Age Group:
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Grades 9th-12th; 3:00pm-5:00pm
Medical Information: Does the participant have any medical conditions or allergies that we should be aware of?
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Yes
No
Medical Information:
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Submit
Should be Empty: