Holiday Lake 4-H Educational Center

Wilderness Survival and Outdoor Living Skills Weekend >
March 23-25,2012

Fill out & submit the form below and mail it in with your check.

Wilderness Survival and Outdoor Living Skills Workshop
Full Name
First Name Last Name
E-mail

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number
- Area Code Phone Number
Gender

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Please register by: March 9, 2012

Full: by March 9, 2012
50% : after March 9, 2012
Nonrefundable after March 16, 2012

Mail Check to:
Holiday Lake 4H Educational Center
1267 4-H Camp Road
Appomattox, VA 24522

If you are a person with a disability and desire any assistive devices, services or other accommodations to participate in the Workshop, please contact The 4-H Center no later than two weeks prior to the date assistance is needed between the hours of 8:00 a.m. - 4:30 p.m. Monday through Friday.

Holiday Lake 4-H Educational Center programs and employment are open to all, regardless of race, color, national origin, sex, religion, age, disability, political beliefs, sexual orientation, or marital or family status. An equal opportunity/affirmative action employer.

Wilderness Survival and Outdoor Living Skills Weekend > March 23-25,2012

Wilderness Survival and Outdoor Living Skills Workshop

Wilderness Survival and Outdoor Living Skills Weekend >
March 23-25,2012