Camp Kupugani
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Primary Contact for account

Enter the information for the primary contact for this account. This person must be an adult.
First Name:

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Middle Initial:
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Address:

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Zip / Postal Code:

Please describe your race(s) / ethnicity(-ies). Providing the information in is optional, yet it would be tremendously helpful if you did. Because we are addressing issues of difference, it is essential that we have a diverse group of campers. We not only strive for racial/ethnic diversity, but also for diversity of socio-economic class, religion, culture, personality, etc. This information will be used only to determine this balance.
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Please describe any other ways by which you identify yourself that you would like to share with us (Such as socio-economic class, religion, culture, background, etc.)
Primary Phone
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E-mail Address:
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Roles:
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The username and password must consist only of letters and/or numbers.  No special characters or spaces are allowed.
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Password:
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6903 W. White Eagle Rd. • Leaf River • IL • 61047 • (815) 713-4110
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