Print and Mail along with your waiver to:

Dinosaurs Rock
1 Penny Lane, Montebello NY 10901

DINOSAURS ROCK 3-DAY UTAH DIG

REGISTRATION FORM

Spaces are filled on a first come first serve basis

NAME 1) ________________________  

NAME OF OTHER FAMILY MEMBERS & AGES OF CHILDREN

2)      _______________________  Age__________________________

3)      _______________________  Age __________________________

4)      _______________________ Age ___________________________

5)      _______________________  Age __________________________

MAILING ADDRESS _____________________________________________________

CITY _________________________ STATE ___________________ ZIP __________

TEL (day) _______________ TEL (eve) ______________CELL # __________________

E-MAIL  ADDRESS: ______________________________________________________

• Waiver of Liability & Guidelines form must be returned with Registration Form

DINOSAURS ROCK will forward contact phone numbers and meeting directions at least 2 weeks prior to the tour.

_____ Please initial this space if I DO NOT want my name, mailing address and e-mail address to be shared with other participants

• All payments payable by check to DINOSAURS ROCK

• Fee is $700 per person, children 3 and under are free.  
           

Total # __________   x $700  =    I have enclosed  $_________________

DINOSAURS ROCK

1 Penny Lane, Montebello, NY 10901  www.DinosaursRock.com  800-411-3466 info@dinosaursrock.com