Program/Event Name:

Program/Event Date:

First Name:

Last Name:

Email Address:

Additional people you are registering for? Y N

If so, how many? Adults Children

Phone Number:

Payment (please check one):
I am mailing a check made payable to: Heritage Trail Association.
I am bringing check/cash payment on event day (some events must be prepaid)

Note: Heritage Trail Association is unable to process credit cards at this time.

How did you hear about this event (please check)?
Newsletter
Local Media
Website
Other, please explain: