Earthways
Guided Canoe Trips & School of Wilderness Living

REGISTRATION

Printable Registration (pdf file) ~ Printable Registration (doc file)

Please Print and Mail this Registration Form.

Mail to: EARTHWAYS REGISTRATION FORM, 159 Earthways Rd, Canaan, ME. 04924

NAME ______________________________________________________________

ADDRESS ___________________________________________________________

CITY ________________________ STATE ______________ ZIP ______________

SEX ______ AGE _______ OCCUPATION _________________________________

WORK TEL _____________________ HOME TEL ___________________________

GROUP CONTACT PERSON _____________________ GROUP SIZE __________

AGE RANGE: FROM ________ TO ________ NUMBER OF M ________ F _________

HOW DID YOU HEAR ABOUT US? _______________________________________

______________________________________________________________________

TRIP/CLASS CHOICE: ___________________________ DATES ________________

DEPOSIT ENCLOSED $ ___________________ (BALANCE DUE 30 DAYS PRIOR
TO CLASS/RIVER TRIP)

EMERGENCY CONTACT ________________________________________________

HOME TEL _______________________ WORK TEL __________________________

A non-refundable deposit of U.S. $200.00 per person must accompany registration
for all trips and classes over $200.00, with balance due 30 days prior to trip or class. Any class/trip under $200.00 prepay in full. Send payment with registration form for all trips/classes. After receipt of your registration and deposit/payment, you will be sent a receipt and any information you will need for our classes or river trips. Prices subject to change without notice. Class/trip schedule is also subject to change. If we cancel a class or trip we will refund your deposit. It is your responsibility to notify us of any medical needs or special dietary considerations.

Food (s): ________________________________________________________
Current or Past Medical problems: ___________________________________________
Doctor's name: _________________________ Phone _____________________

My signature indicates my desire to participate at Earthways and that I understand the terms:

SIGNATURE _________________________________ DATE ______________

Earthways
159 Earthways Road, Canaan, Maine 04924
Phone: (207) 426-8138
The use of email has been unreliable so we can only be contacted by telephone at this time.
Copyright © 2006, 2007 Earthways - All rights reserved.