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2024 Summer Conditioning Camp by ECB

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First Name:*

Middle Name:

Last Name:*

Date of Birth:*

Please select the grade your child. This camp is for 3rd-9th graders only. :*

Are there any medical conditions/health concerns (allergies) we should be aware of?:*

Yes

If yes, list medical condition here. :

Email:*

Emergency Contact 1 First Name:*

Emergency Contact Last Name:*

Emergency Contact Phone Number:*