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2017 Little Troy Park Membership Application

Name(s)________________________________________________

Children:
Name _______________ Age  ____  Name_____________  Age_____

Name________________Age_____ Name______________ Age_____

Name________________Age_____ Name______________Age_____

Address_________________________________________________

City__________________________________ ZipCode___________

Telephone_________________

E-mail_________________________

Sponsored Child__________________________________________

Type of Membership:  Please circle    Family    Mini                                                          Single    Couple   Sponsored child

Amount Enclosed:______________    Ck. #_________  Cash_______   

    Make checks payable to "Little Troy Park"             

    Mail to Little Troy Park/Membership, P.O.Box 273, Burnt Hills, NY 12027                                   Telephone: Laura @ 369-4180

New members: How did you hear about Little Troy?____

______________________________________________________