REGISTRATION FORM FOR ROSA PARKS GOURMET CAMPING TRIP

REGISTRATION FOR ROSA PARKS GOURMET CAMPING TRIP

JUNE 13-15, 2014

Suggested Cost:  $70/per person.  Sliding scale option available.

FAMILY NAME:  ___________________________________

EMAIL:  _______________________________

NUMBER OF ADULTS: ______; # CHILDREN:  ______

DIETARY RESTRICTIONS:  __________________

PAYMENT AMOUNT: ______________