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High School Summer Retreat Payment Page

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  Number of Participants REQUIRED Please fill out this field.
  
  Participant Information: 1
  
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  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Parent E-mail: Please enter valid data.
  
  Parent Cell Phone: Please enter valid data.
  
  Amount paying: REQUIRED 50.0 – Deposit 175.0 – Full Amount 0.0 – Other Amount 0.0 – Pay by Check Please fill out this field.
  
  Indicate amount: $ Please enter a positive decimal.
  
  Participant Information: 2
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Parent E-mail: Please enter valid data.
  
  Parent Cell Phone: Please enter valid data.
  
  Amount paying: REQUIRED 50.0 – Deposit 175.0 – Full Amount 0.0 – Other Amount 0.0 – Pay by Check Please fill out this field.
  
  Indicate amount: $ Please enter a positive decimal.
  
  Participant Information: 3
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Parent E-mail: Please enter valid data.
  
  Parent Cell Phone: Please enter valid data.
  
  Amount paying: REQUIRED 50.0 – Deposit 175.0 – Full Amount 0.0 – Other Amount 0.0 – Pay by Check Please fill out this field.
  
  Indicate amount: $ Please enter a positive decimal.
  
  Participant Information: 4
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Parent E-mail: Please enter valid data.
  
  Parent Cell Phone: Please enter valid data.
  
  Amount paying: REQUIRED 50.0 – Deposit 175.0 – Full Amount 0.0 – Other Amount 0.0 – Pay by Check Please fill out this field.
  
  Indicate amount: $ Please enter a positive decimal.
  
  Participant Information: 5
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Parent E-mail: Please enter valid data.
  
  Parent Cell Phone: Please enter valid data.
  
  Amount paying: REQUIRED 50.0 – Deposit 175.0 – Full Amount 0.0 – Other Amount 0.0 – Pay by Check Please fill out this field.
  
  Indicate amount: $ Please enter a positive decimal.
  
  Participant Information: 6
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Parent E-mail: Please enter valid data.
  
  Parent Cell Phone: Please enter valid data.
  
  Amount paying: REQUIRED 50.0 – Deposit 175.0 – Full Amount 0.0 – Other Amount 0.0 – Pay by Check Please fill out this field.
  
  Indicate amount: $ Please enter a positive decimal.
  
  Total:
  
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