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 Club Name

 
Trip Leader    
EMAIL ADDRESS  
HM PH# WK PH# CELL#
 

ROOMING LIST

Rooms Full Name

(Last,First)

 Full Name

(Last,First)

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TOTAL AMOUNT ENCLOSED: $________________________________________

 

$50 Per person Deposit due 11/01/09

Final Balance due 2/1/10

Pillow deposit is non-refundable

 

Make check payable to “NBS Midwest Region”

Send To:    Dean Cook

Address:      734 Yorkhaven Road

                     Cincinnati, Ohio 45246 

 

Phone:         (513) 825-2974 home 

Email:          This e-mail address is being protected from spambots. You need JavaScript enabled to view it

 


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Club Spotlight

Thrillseekers, Inc

Thrillseekers, Inc

Regions: New York

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Clubs Directory last update: 2010-02-22 22:50:50