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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: LittleTroyPark/Membership   Box 273  Burnt  Hills, NY 12027   

Or payment  & membership form can be brought to the park during park hours


New members: How did you hear about Little Troy?

____________________________________________________________________

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