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2011 registration form camp

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2011 registration form camp Powered By Docstoc
					                                          LANGUAGE ART CAMP REGISTRATION
STUDENT NAME: ________________________________________________________________________

GRADE: _____________________________________________________AGE:________________________


MOTHER: _________________________________                     FATHER:_________________________________


ADDRESS: _______________________________________________________________________________

__________________________________________________________________________________________


PHONE #:____________________________CELL______________________                       OTHER ________________


SCHOOL: ________________________________________________________________________________


T-SHIRT SIZE: YS ____ YM____ YL ____ YXL _____ AS _____ AM ____ AL_____ AXL ______

PIANO LESSON: YES ____ NO _____                  DRUM LESSON: YES ____ NO ______
(Additional $25.00 per week for each Lesson)


EMERGENCY:

NAME ________________________________________ PHONE: _________________________________


NAME ________________________________________ PHONE: _________________________________


CHILDREN CAN BE PICKED UP BY:

NAME: _________________________________ NAME____________________________________

NAME: _________________________________ NAME____________________________________



1925 Ursuline Avenue, New Orleans, LA 70116 504-822-3485 504-822-8138 Email Address: info@stjamesmc-no.org

				
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