Date: June 3rd – 8th
Cost: $150/ $175 after May 19th
Your Name
Email
Address
Contact Number
Parent / Guardian
Parent / Guardian Contact Number
Parent / Guardian Email
Grade GOING INTO 8th grade9th grade10th grade11th grade12th gradeCollege
T-Shirt Size SmallMediumLargeXLXXL
Gender MaleFemale
Scholarship YesNo
Have you accepted Jesus Christ as your personal Lord and Savior? YesNoUnsure
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