DINOSAURS ROCK
3-DAY UTAH DIG – June 27-29,
2010
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 $699 per person, children 3 and under are
free.
Total # __________ x
$699
= I have
enclosed $_________________
DINOSAURS ROCK
1 Penny Lane
, Montebello, NY 10901
www.DinosaursRock.com 800-411-3466
info@dinosaursrock.com
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