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OFFICE USE ONLY 2017 ALSACE TOWNSHIP SUMMER RECREATION PROGRAM REGISTRATION FORM 65 Woodside Ave. Temple PA 19560 Paid Cash Check Amount Phone 610-929-5324 Website alsacetownship.org Please complete the following ONE FORM PER CHILD Cost 80 per child Payment checks payable to Alsace Township or cash in person Program Age Requirement 5 to 14 years old Child s Name Grade Entering in Sept. I the undersigned hereby release Alsace Township its agents and employees from any responsibility for any...
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