CED 172- 90 Health Care Camp

Address *

Phone Number *

Area Code Phone Number
E-mail *
Child's Name *

First Name Last Name
Child's Birth Date *

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Grade that camper will be enrolled in 2019-2020 *
I have been a resident of Maine since: (Note: answer does not exclude you from participating) *
Please let us know if there is anything specific we should know about working with your child
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July 8th, 9:00 am-3:00 pm