Midwest Winter KOGAPE 2021 Registration Form

Registration Fee Calculation

$0.00


Participant's Information

Home Address



Emergency Contact



Please read and accept all.



Medical Form

Clinic or Regular Doctor Address



Parent / Legal Guardian Consent

With my signature below, I attest to the fact that all the information above is true and that I have given approval for the Camp Workshop Staff to provide emergency medical treatment or hospital care for my child ONLY if I cannot be reached or am unable to be contacted.


$0.00


Billing Information

  • Visa
  • Mastercard
  • American Express
  • Discover
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