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ARE PARENTS DIVORCED OR SEPERATED?

NAMES(S) OF PERSON(S) OTHER THAN PARENT(S) AUTHORIZED TO ACT FOR PARENT IN CASE OF EMERGENCY:



Activity Fee $25.00 per child (one-time, nonrefundable)
Please check "Payment: $100" box below to include your payment with your registration.
(*REGISTRATION PAYMENT IS REQUIRED BEFORE FORM CAN BE SUBMITTED!)
Registration: $100
Activity Fee: $25
$0.00