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Tion First Name Last Name Organization Mailing Address City State Telephone # E-mail Address (required for confirmation) Zip Academy Options Academy Start Date (MM/DD/YY): Academy Location: Registration Options T-Shirt Size I am registering as: 1-4 Student(s) from the same organization $475.00 per person 5+ Students from the same organization $400.00 per person Payment and Submission Options Medium X-Large 2X-Large Large Other: Disability Requirements I purchased this form o.

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