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Early Fall 2016 Program(s) Registration Form
Please fill out all information; Scroll down to the bottom of the form and click the submit button. Enrollment is limited. Your program enrollment will be confirmed by email. Questions? Contact Kate at (860) 868-9131 or info@steeprockassoc.org.
Primary Contact Information
Once primary contact information is complete, scroll down to provide information on additional attendees. Age is only required if attendee is under 18 years old.
First and Last Name: *
Your answer
Mailing Address (Street or P.O. Box): *
Your answer
City: *
Your answer
State: *
Your answer
Zip Code: *
Your answer
Home Phone Number: *
Your answer
Mobile Phone Number
Your answer
Email Address: *
Your answer
Programs that I/we will attend:
Please select all that apply.
Will you be attending with a guest(s): *
If yes, how many guests will you be bringing to Snakes of Connecticut:
Your answer
If yes, how many guests will you be bringing to River Bug Hunt:
Your answer
If yes, how many guests will you be bringing to Hike the Roxbury-Tunnel Road Connector
Your answer
If yes, how many guests will you be bringing to Holiday House Hike?
Your answer
Please provide the age(s) of any guests under the age of 18 for Snakes of Connecticut:
Your answer
Please provide the age(s) of any guests under the age of 18 for the River Bug Hunt:
Your answer
Please provide the age(s) of any guests under the age of 18 for Hike the Roxbury-Tunnel Road Connector:
Your answer
Please provide the age(s) of any guests under the age of 18 for Holiday House Hike:
Your answer
Please click the submit button to register for programs at Steep Rock Association.
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