Wilson County Cowboy Camp

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Child's Info

Child's Full Name

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Child's Gender

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Male Female

Date of Birth of Child

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Current Grade

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Kinder 1st 2nd 3rd 4th 5th

Does this child have any allergies?

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Photo Consent

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Parent/Guardian's Info

Parent/Guardian's Full Name

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Relation To Child

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Parent/Guardian's Cell

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Parent/Guardian's Email

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Mailing Address

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Home Church

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Emergency Contact (must be a different adult)

Emergency Contact Full Name

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Emergency Contact Phone

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Relation to Child

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Description

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