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Welcome
Additional Attendees
Registration Record
Welcome
Additional Attendees
Registration Record
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Student First Name
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Student First Name
Student Last Name
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Student Last Name
Parent/Guardian First Name
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Parent/Guardian First Name
Parent/Guardian Last Name
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Parent/Guardian Last Name
Parent/Guardian Email Address
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Parent/Guardian Email Address
Address Line 1
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Address Line 1
Address Line 2
Address Line 2
City
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City
US State
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US State
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Zip (Postal Code)
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Zip (Postal Code)
Phone Number
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Phone Number
Student Email Address
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Student Email Address
School Name
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School Name
2023 - 2024 Academic Year Grade
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2023 - 2024 Academic Year Grade
6th
7th
8th
9th
10th
11th
12th
Shirt Size (adult sizes)
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Shirt Size (adult sizes)
X-Small
Small
Medium
Large
X-Large
Comments
Comments
How did you hear about UCI Brain Camp?
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Email
Email
UCI Website
UCI Website
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Twitter
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