Nature Awareness School - Application Form - Courses in in survival skills, tracking, wild edible plants, personal awareness, and nature awareness.">

Nature Awareness School

P.O. Box 219, Lyndhurst, VA 22952 (540) 377-6068

2008 Nature Awareness School Application

Name ____________________________________________________ Age _____
Street Address_______________________________________________________
City, State, and Zip___________________________________________________
Home phone ______________________ Work phone _______________________
Emergency contact (name, address, phone) ________________________________
___________________________________________________________________
Your occupation _____________________________________________________
Medical conditions or physical limitations _________________________________
For meal planning purposes - Any special needs? ___________________________
Special interests or hobbies related to this course ____________________________
___________________________________________________________________
Other wilderness schools attended _______________________________________
Previously attended Nature Awareness School courses _______________________
How did you hear about this course? _____________________________________

RELEASE: My signature below certifies that I am in good physical condition and am willing to participate in this program. I hereby assume all risks related to my participation. I release for myself, my heirs and my executor any claim against the Del Hall, F.U.N.,Inc. and its employees and agents from liability resulting from injury or accidents occurring during this course. I give permission for F.U.N., Inc. to use photographs that may be taken during my class, in promotional materials.
Signature __________________________________ Date ______________________________

Cost of WEEKEND courses
$225.00 or $255.00
Please send non-refundable
deposit of $95.00.
(An additional amount of $160.00
is payable on first day of class or
$130.00 payable if received
14 days prior to start of class.)
$ __________

Cost of 3-DAY courses
$335.00 or $375.00
Please send non-refundable
deposit of $135.00.
(An additional amount of $240.00
is payable on first day of class or
$200.00 payable if received
14 days prior to start of class.)
$ __________

Cost of WEEKLONG courses
$675.00 or $750.00
Please send non-refundable
deposit of $225.00.
(An additional amount of $525.00
is payable on first day of class or
$450.00 payable if received
14 days prior to start of class.)
$ __________

Date and course for which you are applying: ________________________________
Payment method: Check _____ Visa _____ MasterCard _____ Discover _____
Name as it appears on card: _____________________________________________
Account # _______________________ Expiration date: __________ Please make checks or money orders payable to F.U.N., Inc.
Note: EACH applicant must fill out an application. Please make copies of this application if necessary. Those under 18 years of age must have a parent or guardian sign their application.

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