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* 1. Student's Name

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* 2. Grade Level for 22-23 School Year

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* 3. Parent Name

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* 4. Parent Phone Number

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* 5. Parent Email

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* 6. Student's Cell Number

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* 7. Health Insurance Provider

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* 8. Doctor's Name

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* 9. Doctor's Phone Number

The fee for the VCPS Summer Workout Program is $50. Checks should be made out to Valley City Public School or VCPS and dropped off at the Valley City Jr. High office or mailed to:  Attention Rob Hunt, Valley City Public School, 460 Central Ave. North, Valley City ND 58072
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