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

West Virginia State Parks does not sell your name and address. On limited occasion, information is forwarded by mail or email concerning specials offered for camping or cottage rentals at parks, forests or wildlife management areas.

Circle this statement if you prefer no contact.

DISCLAIMER: "It is the policy of the West Virginia Division of Natural Resources to provide its facilities, accommodations, services and programs to all persons without regard to gender, race, color, age, religion, national origin or disability. Proper licenses, registration and compliance with official rules and regulations are the only sources of restrictions for facility use or program participation." "The West Virginia Division of Natural Resources is an equal opportunity employer."