Upper Merion Township
Skate Park
Brick Walkway Order Form
NAME:
ADDRESS:
PHONE:
EMAIL:
ENGRAVING PLEASE PRINT
4”X8” ($25)
4”X8” Bricks may contain 3 lines of up to 16 characters per line (including spaces and Punctuation)
8” X 8” ($50)
8”X8” Bricks may contain 4 lines of up to 16 characters per line (including spaces and Punctuation)
12” X 12” ($80)
12” X 12” Bricks may contain 6 lines of up 20 characters per line (including spaces and Punctuation)
12” X 12” Business/ Corporate ($100)
Attach business or corporate logo to order form
Example
Order forms may be mailed or turned into Upper Merion Park and Rec Office
175 Valley Forge Rd King of Prussia Pa 19406
Make Check Payable to “Upper Merion Foundation” (memo- skate park brick)