Print this page, complete the form below, and send it with your tax-deductible check of $30 for each person joining, plus any additional donation.

$5,000 – Benefactor Membership & 4 Tickets

$2,000 – Defender Membership & 4 Tickets

$1,000 – Advocate Membership & 4 Tickets

$500 – Supporter Membership & 4 Tickets

$250 – Protector Membership & 4 Tickets

$120 – Family Membership & 4 Tickets

$30 – Single Membership & 1 Ticket

Payable to: Canobie Lake Protective Association or CLPA

Mailing address: PO Box 13, Windham, NH 03087

Membership Information:

Name(s):______________________________________________________________

Address:______________________________________________________________

City:_______________________________________ State:_______________ Zip:____________

Email address:__________________________________________________________

Telephone:____________________________________________________________

Check Donation Type:

____________ New Member_______________ Renewal _______________ General Donation

Total Membership ($30 per person) $_____________

Name of each person's membership:

Name:_________________________________________________

Name: __________________________________________________

Additional Donation $____________________

Amount Enclosed $_____________