Troop 125 50th Anniversary Registration Form
Sunday September 15, 2019 3 to 7pm at Constantino Brumidi Lodge- 2075 Deer Park Avenue, Deer Park NY

Tickets are $20 per person, children aged five and under are Free.

Once you have filled out this form, please send your check made out to "Troop 125" to
Robyn Chacon at 12 West Farms Lane, Commack, NY 11725

Payment due by August 18, 2019 ~ No tickets sold at door

Questions? email us at: troop125events@gmail.com

Email address *
Your answer
Last name *
Your answer
First name *
Your answer
Street Address *
Your answer
City, State Zip *
Your answer
Scouts' names, if applicable
Your answer
Year scout started in Troop 125
Your answer
Year scout left, if applicable
Your answer
Number of tickets (Ages 6 and above) *
Number of tickets (Ages 5 and under)
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