TOTAL _________________________ NAME |
AGE |
GENDER |
DORM ROOM $12.00 |
MEALS |
T-Shirt |
RV HOOKUP $20.00 |
TOTAL |
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TOTAL _________________________
JURISDICTION: ____________________________________________________________________________________
CONTACT PERSON: ________________________________________________________________________________
ADDRESS: _________________________________________________________________________________________
PHONE: ___________________________________________________________________________________________
EMAIL: ____________________________________________________________________________________________
HIGH PLAINS HIKE
REGISTRATION DUE APRIL 1, 2010