Donations & Fundraisers

Squirrel Cage Pavers

Name:	First: Last:
Address:
City:	State: Zip:
Phone:	E-Mail:
Please engrave bricks at a cost of $100 each.
Engraved name and/or message: (limit 14 characters per line, each brick may have 3 lines)

Payment Information Charge this amount: $to my
Account # Exp. Date:

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2007 Camp Ho Mita Koda