Guest Registration for That's My Brick Fundraiser - That's My Brick (Purchase)

Code	Activity	Ages	Grades	Days	Dates/Times	Location	Fees
	That's My Brick (Purchase)	N/A	N/A		04/17/2024 - 09/01/2024		$100.00

Participant Information

*First Name	*Last Name
		I am a Resident or Taxpayer of Harpswell, Maine I am NOT a Resident or Taxpayer of Harpswell, Maine

Birth Date	Grade	Gender
(mm/dd/yyyy)

* Inscription on brick? Up to 3 lines, 16 characters (including spaces) per line. Please double check carefully!