Rotary Club Registration

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Rotary Club Registration

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Step 1 of 3

Club Contact for Camp RYLA

Rotary District*

Club Name*

Name*

First Last

Role*

(Youth Svc Chair, Guidance Counselor, etc.)

Email*

Phone*

Sponsored Students

Number of Sponsored Students*

Student 1

First Last

Student 2

First Last

Student 3

First Last

Student 4

First Last

Payment will be by:*

Check

Credit Card

Total

captcha*