Name _______________________________________
Address ____________________________________
Phone ______________________________________
Email ______________________________________
Membership:
New ___Renew ___Lakefront (30.00) _____ Senior (20.00) ____
New ___Renew ___Associate (20.00) _____
4th of July Celebration Donation ________
Total =======
To receive newsletters and be invited to the picnic please fill out this form and return
LMCA
PO Box 7578
Covington, WA 98042-0044
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