Yes! I am interested in attending the West Goshen Township trip to the Statue of Liberty and Ellis Island on April 19, 2008!

Name:_______________________Telephone:__________________

Address:_______________________________________________

______________________________________________________

Number of adults:      _______ x $50: _____

Number of seniors:     _______ x $45: _____

Number of children:    _______ x $40: _____    Total Payment:_______
(12 years old or younger)                                      Please make checks payable to "West Goshen Township"

Please inform of future West Goshen trips via email at ______________

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