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Chicks in the Sticks - Register by mail

Instructions
Step 1: Complete this form
Step 2: Click the PRINT button at the bottom. (printer required)
Registration is $45.00 payable by check to PPFF with Oil Creek on memo line.
Send form and check to:
Christine Owens
905 Township Line Rd.
Seneca PA 16346
You must be at least 18 years old to participate All field are required.

To get a shirt registration must be received by May 28,2017

Small Medium Large X-Large XX-Large No Shirt
Program Selection

Please choose four(4) classes and four(4) alternates. Every effort will be made to provide your first choice.




Participant Release

The participant, by submitting this form, acknowledges this program involves some risk and she/he assumes responsibility for her/his action and for any injury that may result from participation and also waives and releases all other participants, the host, sponsors, instructors, officials and/or other parties involved in the event from all claims and/or damages/injury in connection with this event. In addition, participant grants the Friends of Oil Creek State Park the unconditional right to use the name, voice and photographic likeness of the person listed above, in regards to any of the publications and audio/video productions.
By submitting this form you agree to the Release. Signature: ____________________________________________ Date: __________________