Print this page, fill it in and mail it with a self-addressed, stamped envelope to:

Lincoln Park District

1400 Primm Rd.

Lincoln, IL 62656

Address:_______________________________

City:__________________________________

Home phone:____________________________

Business/

emergency phone:________________________

Zip Code:______________________________

T-shirt size (if applicable) circle one - Youth / Adult   S   M   L   XL

Total Payment:  ______________________

***Please include session numbers on check.***

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