| Tricia's Dance Extreme |
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| Lehighton Bike Night Lil Mr & Ms Lehighton Bike Night |
COME STRUT COOLEST STYLE !
And YOUR BIKER
Child
Name:___________________________
Parents
Name/Mother:______________________
Father:______________________
Address:____________________________
___________________________________
Phone Number:______________________
Birthdate:_______________________
Age as of Aug 9, 2008:________________
Boy________ Girl________
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Registration Fee of $10
Deadline Aug 1,2008
Ages 3-6
Money Order Payable to :
Tricia's Dance Extreme
Please Mail Form and Money Order To:
Tricia's Dance Extreme
Tricia Hettler
302 Coal St
Lehighton, Pa 18235
Lehighton Park Band Shell
Check in at 3:00pm
Pagent starts at 3:30pm
Forms are available at
Deet's Cuts and Curls
The Bike Shop