WPCK ( qK"H!Y Y[x6|0P{]&K{]$vNfecDaV V .N.o>Uؑ?ݑ"!=!F+*͘]cL&}voRMoZG ȍGJ{VeôRSuTպO)@I«ߟ_G&b= b//o % _)^Jn?$GA)LvC ~|+%U{> ^P^.1FƀȁGa)eP#2@m$;0JQeҨ"tatzт.IaG 04U8U .LU8zU.#UN %N^ w 4#2 m4( ;$ US Z#>Z Arial-BoldMTZ#>ZArialMT$Z Trebuchet MSLB ZCalibrihp color LaserJet 2550 PS0(9 Z6Times New Roman RegularX%{8 Ys8:i+003|xU ;!USUS.,  _ }   gXXdg REGISTRATIONFORM  d (Pleaseprintallinformationandlistadditionalnamesonaseparate  paper.) H  }   WPARTICIPANT_________________________________________________________________________   DAYPHONE___________________________EVENINGPHONE___________________ d  ADDRESS_____________________________________________________________________________  ]  CITY_______________________STATE____________ZIP__________________     WMUNICIPALITY________________________________ _     _  EMERGENCYINFORMATION  Incaseofemergencypleasecontact:     _  NAME_______________________________________________RELATION__________________ 6 ADDRESS____________________________________________PHONE______________________  DOCTORSNAME_____________________________________PHONE______________________ \ HOSPITALPREFERENCE:  YORK h MEMORIAL   p OTHER___________________ ? LISTANYPHYSICALLIMITATIONS/DISABILITIESORALLERGIES:  ԀDoverAreaRecreationorDoverTownshipwillnotassumeanyliabilityforaccidents.Participants  e herebyassumethisresponsibilitywhenregistered.  '  ______________________________________________ " _____________________ParticipantsSignature   p      D#   Date $V ԀPROGRAM/EVENT_____________________________COST________________DATE %! OFEVENT_______________________________#OFPARTICIPANTS__________ [&! AMOUNTENCLOSED$_________________________ 'U"   Foradditionalinformationorreservationscall292-3634orfillintheattachedformandreturnto:Dover (# Township2480W.CanalRd.Dover,PA17315ATTN:Recreation.Makecheckspayableto DOVER Z)$  TOWNSHIP .Xc.XX7o XXXc.ԀIfe-mailingthisform,pleasefollowupwithpayment.Thankyou. "*r%! %& % XX7o%g % %%&