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Name _________________________________________________________
Address ___________________________________ ____________________________
City _____________ ______
Zip _____________
Home Phone( __ ) ___________________
e-mail _________________________________ _______________________
Current School:
__________________________________________________________________
Please make check payable to
Lutheran High Northwest
1000 Bagley
Rochester Hills, MI. 48309
(248) 852-6677
Contact information
for the camp:
Ron L. Perfetto —
ronperfetto@yahoo.com H–586-416-1070
C–586-909-7138
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