| Date Created | September 12, 2023 |
|---|---|
| Participant's Name | Esther Jorgensen |
| Participant's Age | 17 |
| Parent/Guardian Name | Emily Jorgensen |
| Parent / Guardian Cell Phone Number | (385) 204-1064 |
| Parent / Guardian Email | Email hidden; Javascript is required. |
| Team Placement | Holomua Team |
| Parent E-Signature | Emily Jorgensen |
| Date | 9/12/23 |
| Participant E-Signature | Esther Jorgensen |
| Date | 9/12/23 |