Backpack School Registration Form
Name:______________________________
Address:____________________________
City:_______________________________
State:_____________ Zip:______________
Phone Number
Day:___________________________
Evening:________________________
Age:_______________
Physical Activities you regularly engage in.
___________________________________
___________________________________
______ Backpack Course $50.00
______ Total Amount enclosed.
Please send your payment (checks only, payable to Miami Group Sierra Club) to:
Backpack School
c/o Mike Clinkenbeard
3653 Boudinot Ave.
Cincinnati, Ohio 45211
Confirmation of registration and additional information will be sent to you upon receipt of application. |