SPECIAL EVENTS & FIELD TRIP REGISTRATION FORM

There are three ways to register for special events/field trips:

1. Print this page, complete the form and mail it in
2. Download a MS Word version of the form, complete it and mail it in
3. Download a PDF version of the form, complete it and mail it in

SENIOR COLLEGE
University of Maine, Hutchinson Center
80 Belmont Avenue, Belfast, ME 04915

Name _______________________________________

Telephone ___________________________________

Event _______________________________________

Date of event: ________________________________

Amount enclosed/received ______________________

___ I am a member of Senior College

___ I am not a member of Senior College

All trips are subject to cancellation when there are not enough registrants. Payment is final, but refundable if the trip is cancelled. If any registrant cancels prior to the trip, his or her money will be refunded only if there is a waiting list. Please call Vicky Sears, chair of the Special Events Committee, at 338-1891 with any questions.

Through my signature on this registration form, I agree to hold harmless for any personal injury claims the University of Maine Senior College and the University of Maine/Hutchinson Center.

_____________ (date)

_____________________________ (signature)

Senior College admits members regardless of race, color, sexual orientation and national or ethnic origin.