The number of pages within the document is: 3
The self-declared author(s) is/are:
Original authors did not specify.
The subject is as follows:
Original authors did not specify.
The original URL is: LINK
The access date was:
2019-02-16 14:17:24.578310
Please be aware that this may be under copyright restrictions. Please send an email to admin@pharmacoengineering.com for any AI-generated issues.
Loading...
Reload document 
Open in new tab The content is as follows:
124 Atkins Avenue, Asbury Park, NJ 07712 (732) 774-5347 inspirelife124@gmail.com Inspire LIFE Fine Arts & Technology Summer Camp Monday- Friday, August 13 –August 24, 2018 8:30 am – 3:00 pm Student Registration Form First Name _________________________________ MI ______ Last Name ___________________________________ Date of Birth __________/ ________________/ _________________ Age ________ Male or Female Address _______________________________________________________________________________________________ City ____________________________________ State ____________ Zip ____________________________ Phone: ________________________________ Email: _________________________________________________________ Parent/ Guardian: ____________________________________________ Relationship to Child ____________________________________ ____________________________________________ Relationship to Child ____________________________________ School: _________________________________________________ Grade: _______________________________________ Emergency Contact Name: ______________________________ Relationship _____________________________ Emergency Contact Phone: ____________________________ (cell) _______________________________ (home) Do you have a church home? ______ NO. If YES, where: __________________________________________________ At the 3:00 pm dismissal will your child… _________________ Walk _________________ Pick up Pick up #1 ___________________________________________ Relationship _________________________________ Pick up #2 ___________________________________________ Relationship _________________________________ Child T-Shirt Size: YM YL AS AM AL XL XXL Please indicate all food restrictions or allergies: ________________________________________________________
Please note all content on this page was automatically generated via our AI-based algorithm (9S4CXrcoKKN4KTdkOJB2). Please let us know if you find any errors.