

| KERMIT CELEBRATION DAYS 2012 City of Kermit 110 Kermit The Frog Blvd. Kermit, Tx. 79745 Phone 432/586/3460 www.kermittexas.us Fax 432/586/2220 REGISTRATION FORM September 22nd and 23rd - 2012 |
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| NOTICE: $25 deposit required @ initial registration. The balance shall be paid in full before Sept. 14, 2012 or your site location will be forfeited. |