Knight Camp Wait List – Northwest Fencing Academy

Eligibility Verification *

I certify my child is a 4J Student Who Will Enter Grade 6, 7, or 8 in Fall 2021 OR participated in the Summer 2021 Sword Program

Student Name *

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Last

Parent/Guardian Name *

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Last

Parent/Guardian Address

Address Line 1

Address Line 2

City

State

Zip Code

Parent/Guardian Phone *

Parent/Guardian Email *

Student Age *

Grade Student Will Enter in Fall 2021: *

School or Program Child Will Attend in Fall 2021 *

Optional - About My Child (interests, learning style, medical, etc)

Contact Name

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Last

Contact Phone

Additional Contact Name

First

Last

Additional Contact Phone