Hike & Write Registration
by DIG-IT
Nature Writing Workshop by DIG IT! Magazine
Hike & Write
REGISTRATION FORM
Saturday, April 26, 2014; 10:00am to 1:00pm
Hacklebarny State Park, 119 Hacklebarney Rd, Long Valley, NJ
Fee: $35 per person
Payment must accompany registration (unless pre-arranged)
Class size is limited; no refunds after April 21
Please make check or money order payable to Mary Jasch.
Mail to: Mary Jasch, PO Box 397, Augusta, NJ 07822
Limited to 15 people. First come; first serve.
Not handi-capped accessible
Please fill out all fields.
Name (print): ___________________________________________
Street Address:__________________________________________
Town, State, Zip:________________________________________
Home Phone:______________________________________________
Cell phone: _____________________________________________
Email:___________________________________________________
Emergency Contact Name: __________________________________
Emergency Contact Phone: __________________________________
Quantity:______ @$35/person per person Total:____________
How did you hear about the Hike & Write? _________________________________
Questions? Contact Mary: mary@dig-itmag.com
Acknowledgment of Risk
We ask you to acknowledge that there is an element of risk in any adventure, travel, sport, or activity associated with the outdoors. We trust that you know of the inherent risks, dangers, and rigors associated with travel in the outdoors, the risk of travel by car, bus, or other vehicles, the risk of disease or illness, and all that is encountered in the natural world and areas of civilization.
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published April 07, 2014
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