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  The Smoke Signals is a newsletter for the South Hills Area YMCA Guide Parent/Child Program
 
 

Registration Form

Kon-O-Kwee                                    Date: May 14-16, 2010
Early Bird Registration Ends 04/30/10
 

Parent First Name
  Last Name 
 

Child Name
 

Tribe Name
  Address
  City
  State
Zip Code
  Evening Phone
  Daytime Phone
  Email Address
     
 

Adults:

  $120 each  (early bird $100 each)
 

Children:

     $55 each  (early bird $50 each)
 

Renew YMCA family membership if expired?    Yes No ($110.00)


Renew YMCA program membership if expired? Yes No ($30.00)

  Name on card
 
  Card Type
MC/Visa Discover American Express
  Card number
  V Code on back
  Exp Date
.Month Year
  Comments
Note: Your YMCA Family Membership and program free must be paid and current prior to your camp-out date.
      

 

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The Smoke Signals is a newsletter for the South Hills Area YMCA Guide Parent/Child Program

South Hills YMCA, 51 McMurray Drive, Pittsburgh, PA 15241
412-833-5600