Please register no more than two people on this form. If you have a larger group and wish to arrange easier registration,
call Nancy at 937-365-0101.

STEP ONE--FILL OUT THE FORM BELOW

Primary Registrant's name
Do you desire Single Private Room, or   a Shared room for two?	Single                Double
Name of Person sharing your Room,  if determined. If not, we will look for someone to share with you
Street Address
City
State
ZIP
Day Phone	necessary for registration
Evening Phone	recommended
3rd Phone	optional
E-mail	necessary for confirmation
Associated Organization (if any)
Position in  Organization (if any)
Associated Website (if any)

If two people, do you prefer shared or separate beds      Shared Bed         Separate Bed 

If you have a lodging partner, is this person included in your registration fee or are they submitting separately?  

                                            Included         Submitting Separately                  

If you do not already have a arranged partner but are willing to share a room, you may register at the lower shared price. In this case, be sure to check "Yes, please look." We will match you with the first available partner of same gender who is also looking to share a room. If we can't find a partner for you, we will still let you come for the reduced shared registration fee. Would you like us to look for you? 
  
                                           Yes, please look           No, I don't need you to find me a partner

Do you have any special dietary desires or food allergies?

Do you have any medical conditions that might require attention while hiking outdoors such as heart condition or allergies to bee stings?
 

We like knowing the backgrounds of the people attending. Do you have an good background or deep interest in a particular natural history topic or realm?

Notes, comments, questions?   Take all the room you need:

STEP TWO SUBMIT EMAIL REGISTRATION

When you are finished reading this page, click on the button below and we will register you, We will send you back an email confirmation within 24-48 hours.

STEP THREE  SEND PAYMENT BY MAIL

Trip fees are $495.00/person double occupancy AND $645/person single occupancy. If you do not need lodging, your cost with meals is $395.00 per person.

A $200.00 deposit is due to hold each person's reservation if you are registering before April 20th. After that time, full registration is due. Sorry, no guarantee on full refunds for cancellations after April 20th unless your space can be refilled by your efforts or our own.

Please note the full trip amount that you calculate you will be owing for all registrants on this form:
Please note the amount you will be sending in the mail at this time:

For maximum accuracy in payment and registration, after you submit this registration we will give you a link for a mail-in payment form to be included with either your deposit or full payment. Please run off the form send it to us in the mail within ten days of your email registration, with your check enclosed. Checks are greatly preferred to credit card payments as we have not included credit card overhead charges (usually around 5%) in our fee structures to keep these programs as affordable as possible.

STEP FOUR:  QUESTIONS?
Call Nancy Stranahan at 937-365-0101 or write director@highlandssanctuary.org.

Thank you so much for registering! So long as the course description does not shows the words: "Course is filled" near the field trip's title, we still have spaces open and your registration is assured as soon as payment is received. If there are any availability issues, we will contact you immediately by phone or email.

THANKS AGAIN! WE ARE GREATLY LOOKING FORWARD TO YOU JOINING US ON THIS TRIP. Please click to submit.