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Justin Wilcox Football Camps

admin@coachwilcoxfootballcamps.com

2227 Piedmont Ave, Berkeley, CA, 94720, US

2020 Justin Wilcox Youth Football Camp Registration

Participant Contact Information

Participant Name

Date Of Birth

Full Address

Parent/Contact

Emergency/Medical Information

Alternate Emergency Contact (Different from Parent/Contact)

Doctor Information

Policy Exp. Date

Policy Holder Name

Medications

Participant Type

Sessions or Days

Day Care 3PM - 5PM

2020 Youth Camp

Session I 400.00
A La Carte 100.00
Aftercare Per Day 25.00
Subtotal

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