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Get Camper Information: STEM Summer Bridge Program 2000-2024

0 (city) Destination: M / (state) F (zip code) Dates of Camp: Parent's/Guardian's Name: In case of emergency, we may contact: (relationship) Doctor's Name: Telephone: Home Telephone: Telephone: - Work Telephone: Date of Last Tetanus Shot: / / Medical Insurance: Policy Number: Student is allergic to:  Bee Stings  Poison Ivy  Ragweed   Other: Medical Considerations:  Asthma  Diabetes  Seizures  Heart Condition  Other: Special Dietary Co.

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