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Add last name if different than parent's

If different

Gender
Student 1 Grade

You only need to fill this out if you're sending multiple students

If different

Gender
Student 2 Grade

If different

Gender
Student 3 Grade

If different

Gender
Student 4 Grade
Product
Full Payment per student$500
Deposit per student$100
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Contact Us

Camp Nageela West

801-613-1-JEW

info@nageelawest.org
www.nageelawest.org

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