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

    T-Shirt Size
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    Gender
    MaleFemale

    Scholarship
    YesNo

    Have you accepted Jesus Christ as your personal Lord and Savior?
    YesNoUnsure