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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) No Printer -See botton of page.
If you print the form you do not need to send the Email.
Registration is $55.00 payable by check to PPFF with Oil Creek on memo line.
Send form and check to:
John Kolojejchick
1238 Shaffer Run Rd.
Oil City PA 16301
You must be at least 18 years old to participate Field with * are required.
(###-###-####)

Have a special request, use the comment field below:
OR send an Email to, John K ASAP

Program Selection

Please choose a class for each of the 4 Sessions.


Every effort will be made to provide your first choice.


Please select 2 alternates in case we can not 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: __________________

No Printer! Send Information by Email Don't have a printer.
By clicking the Email button, your completed registration form will be converted to a simple Email which you can then send to us.
Your schedule will not be processed until We receive your check.