T-Shirt Order Form

14^th Annual Steve Belson Memorial Ocean Swim and Music Festival

Saturday August 1, 2015

Music at the Bungalow Bar – 6:00pm

T-Shirt Order Form

$20.00 Each

Long Sleeve Gray 2 Sided Design

Size	Quantity
Small
Medium
Large
X-Large
XX-Large

Name:                                                                                                                      

Address:                                                                                                                   

                                                                                                                                 

Phone #:                                                                                                                   

Email:                                                                                                             

All proceeds will benefit lifeguards attending college through the

Steve Belson Memorial Scholarship Fund

Cash or Checks payable to

The Steve Belson Memorial Scholarship Fund

Order yours today! There will probably not be many available on

August 1st.

Advanced orders ASAP please!

Mailing address

Steve Belson

Memorial Scholarship Fund

c/o Sean Kellar

522 Beach 140^th Street

Belle Harbor, NY 11694

For more information

Sean & Annie – (347) 410-4126

Brian & Kathy – (516) 432-5326