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Your Name (first and last)
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Child's Name
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age
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Child's Name
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age
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Child's Name
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age
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Child's Name
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age
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Address (line 1)
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Address (line 2)
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City
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State
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Zip
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Home Telephone
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Cell Phone
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Email Address
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Number of family members
participating in
Egypt:
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Emergency contact name
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Emergency contact
telephone
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Allergies or other
medical conditions
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Home church
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Name of a special friend
your child might
like to be with
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