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Printed fromCampGanIsraelSCV.com

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CGI Winter Camp Registration

Camper Information
Full Name

First Name Last Name
Birth Date

Month Day Year
School Attends
Parent 1 Name

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Parent E-mail
Parent Cell

Area Code Phone Number
Parent 2 Name
Parent 2 E-mail
Parent 2 Cell

Area Code Phone Number
Days

Monday Tuesday Wednesday Thursday Friday All Week
Total

$0.00

Payment

Credit Card Check

Should be Empty:

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