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- Date of Birth*
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Format: (000) 000-0000.
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Format: (000) 000-0000.
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- Does the camper have any allergies?*
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- Does the camper take any medications?*
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- Does the camper have any medical conditions or special needs we should be aware of?*
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- Does the camper have any accessibility needs or require accommodations?*
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- Transportation Method*
- If camper will drive themselves, parent/guardian must grant permission. Do you grant permission for your teen to drive to camp?*
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- Select your preferred payment method and reimbursement options:*
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- I consent permission for my child to use the GooseChase App which will be used to enhance participant experiences. I understand that this may include sharing photos and consent to them being used by the participating organizations for content relating to this camp and promotion of future camps.*
- I consent to photos/videos being taken of my child related to camp activities to be used by the participating organizations to create content relating to this camp and promotion of future camps.*
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- Should be Empty: