Hiking Club Registration Form
Please return this registration form for the West Virginia State Park Hiking Program.
You may register your entire family on one form.
Cost is $10.00 per person.
Name: _____________________________________________
Spouse: ____________________________________________
Children: ___________________________________________
Telephone*: ________________________________________
eMail Address*: _____________________________________
Address: ___________________________________________
City: ______________________________________________
State: ____________________ Zip: _____________________
I certify that I am in proper physical condition to participate in this event.
Signature: ___________________________________________
Date: ______________________________________________
Guardian: ___________________________________________
(if under 18)
Date: ______________________________________________
Return Form to :
West Virginia Division of Natural Resources
Parks and Recreation
"Hiking West Virginia"
State Capitol Complex
Bldg. 3, Room 709
Charleston, West Virginia 25305-0662
Please make checks payable to:
Division of Natural Resources
* must provide a phone number &/or email address