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               BOYS SUMMER LACROSSE CAMP


Name_________________________________
Street_________________________________
City______________________Zip__________
Daytime Phone_________________________
Evening Phone_________________________
Cell Phone____________________________
E-Mail Address_________________________
Age______Grade________
Date of birth____/____/____
Parent’s Name____________________

Course Name_BOYS SUMMER LACROSSE CAMP
Beginning Date_JULY 7
Day:TBD

Mail to: Community Education Office
       Orchard Park High School
       4040 Baker Road
      Orchard Park, NY  14127

Make checks payable to:
Orchard Park Community Education