JAMspace
1649 Taraval St.
San Francisco, CA 94122
http://www.jamjamjam.com
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First, please choose your camp day(s):
Tuesday Dec 28
Wednesday Dec 29
Thursday Dec 30
Camper Information
Child #1
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First Name
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Last Name
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Birth Date
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Grade
K
1st
2nd
3rd
4th
5th
6th
7th
8th
Does your child have any allergies or is your child take any medications we should be aware of?
Child #2
First Name
Last Name
Birth Date
Grade
K
1st
2nd
3rd
4th
5th
6th
7th
8th
Does your child have any allergies or is your child take any medications we should be aware of?
Parent/Guardian Contact Information
Your info
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First Name
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Last Name
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Relationship to child(ren)
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Address 1
Address 2
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City
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State
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Zip
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Phone
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Alternate Phone
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Email Address
Other Parent/Guardian/Contact
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First Name
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Last Name
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Relationship to child(ren)
Address 1 (if different from above)
Address 2
City
State
Zip
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Phone
Alternate Phone
Email Address
Emergency Contact Information
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First Name
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Last Name
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Relationship to child(ren)
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Phone
Alternate Phone
Lastly...
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How did you hear about us?
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