Hershey News Years Celebration

KIDS COUNTDOWN CONTEST ENTRY FORM

Hey, Kids!
Help Countdown to 2008 and Raise the Hershey's Kiss on New Year's Eve!

Children ages 4 to 12 are eligible to win a spot on stage


Complete, print and mail this form to:

Hershey New Years Eve Kids Countdown Contest
P O Box 41, Hershey, PA 17033
or
drop off the completed form at the Derry Township Municipal Building
Clearwater Road, Hershey (off of HersheyPark Drive)

Deadline for entry is December 15

Name of Child

Age Category

ages 4-6 ages 7-9 ages 10-12

Name of Parent

Address 1

Address 2

City

State

Zip

Day Phone
Evening Phone

Parent Email

Parent Signature