Yes! I am interested in attending the West Goshen Township
Trip to Radio City Music Hall on Monday, December 5, 2011

Name:_______________________Telephone:__________________

Address:_______________________________________________

______________________________________________________

Number attending:____ Total payment ($150 per person):______

Please indicate email address if you wish to receive information about upcoming trips offered by the West Goshen Township Park and Recreation Department:

_____________________________________________________________

Sorry, we are unable to process electronic payments.
Please return completed Registration Form, along with a Participant Recreation Form for each participant over 18 years of age and a Parental Permission Form for each child under age 18 with payment to:

West Goshen Township
Park and Recreation Department
1025 Paoli Pike
West Chester, PA 19380