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Parish: City:
Adult Contact: Phone:
E Mail Address:
Participants First Name: Last Name: Youth: or Adult:
If fewer than 8 attending : Total number of Youth Participants: X $17.00 =
If 8 or more attending: Total number of Youth Participants: X $15.00 =
Total number of Adult Participants: X $7.00 =
Total amount due when submitted on or before 02/17/2011: