Name: Hands and Feet Camp
Start: 2024-07-23T09:00:00-04:00
End: 2024-07-25T16:00:00-04:00

Student First Name
Student Last Name
Parent/Guardian First Name
Parent/Guardian Last Name
Phone
Email
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Emergency Contact First Name
Emergency Contact Last Name
Emergency Contact Phone Number
Food Allergies
Current Grade
- Third
- Fourth
- Fifth
Birth Date
MM slash DD slash YYYY
Age
Gender
T-shirt Size
If you need financial assistance, Stacey Shafer will follow up with you regarding the request.
- I need to apply for financial assistance.
- I do not need to apply for financial assistance.

Hands and Feet Camp