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Pass Type Quantity Cost Each Total Cost
x $___ ______= $
User and Billing Information
Name:______________________________________
Address:______________________________________
______________________________________
City:____________________________________
State:___________________
Zip:___________________
E-Mail:___________________
Home Phone:_________________________
Work Phone:_________________________ Optional
Fax: Optional
Send a check for the total amount above or fill out the Credit Card Information below
Credit Card Type: Ο Visa Ο Master Card
Name On Card:__________________________________
Credit Card Number:__________________________________
Exp. Date: / /
Make Check Out To: HV Ski LLC
Send To: P.O. Box 216 Two Rivers, WI 54241
Signature________________________________________ Date:__________________
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