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4. Gift Certificate Redemption

  1. Hampton Township Community Center - 3101 McCully Rd, Allison Park, PA 15101

  2. Type of Membership*

  3. Please make a selection:*

  4. You will be asked to provide proof of residency prior to use of the community center amenities. If you cannot provide this information, admittance to the facility will not be granted.

  5. Year of Study*

  6. Must be a Full time college student to apply. A valid college ID must be presented to Service Desk

  7. Are there other family members names to associate with your membership?

  8. Year of Study

  9. Must be a Full time college student to apply. A valid college ID must be presented to Service Desk

  10. Are there other family members names to associate with your membership?

  11. Are there other family members names to associate with your membership?

  12. Are there other family members names to associate with your membership?

  13. Are there other family members names to associate with your membership?

  14. Are there other family members names to associate with your membership?

  15. Are there other family members names to associate with your membership?

  16. Are there other family members names to associate with your membership?

  17. Are there other family members names to associate with your membership?

  18. Are there other family members names to associate with your membership?

  19. Are there other family members names to associate with your membership?

  20. Are there other family members names to associate with your membership?

  21. If only registering youths 3-17 years old, please list Parent/Guardian First and Last Name

  22. Terms and Conditions*

    Answering 'I agree' indicates that I understand the Rules and Regulations, and that I have not misrepresented any information on this form. I also understand that the Township of Hampton will not be held responsible for - or make medical payments for any injuries that may occur during non-supervised programs, activities or events.

  23. Leave This Blank:

  24. This field is not part of the form submission.