Camp Registration Form
Speech-Language Pathology Summer Camp
Which camp are you registering for?
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CAMP DREAM. SPEAK. LIVE. for children who stutter, July 28th - August 1st, 2025
TAP IN to SEL Camp 2025 - August 4th - August 7th, 2025
Both camps
Child’s Name
*
First Name
Last Name
Name of person completing this form
*
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Relationship to Child
*
Date of Birth of Child
*
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Month
-
Day
Year
Date
Age
*
Grade
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Submit
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