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Student's Information: * Required
Student Camp Account     District Donation Account
Student's First Name*:
Student's Last Name*:

Credit Card Holder's Information:
First Name*:  
Last Name*:  
Address*:  
City*:  
State*:  
ZIP:*  
Country:*  
Phone Number:*   (xxx-xxx-xxxx)
Email Address:*  
Total Amount*: *
Description:

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Payment by Credit Card