Event Registration for Natural Shoreline Workshop

Contact Information

* First Name

* Last Name

* Address

Addt'l Address

* City

* County

* State

* Country

* Zipcode

* Phone Number

* E-mail If you supply an e-mail address, a receipt for your registration will automatically be sent to that account. An e-mail address is required to pay using a credit card.

Registration Information

I would like to register for the Natural Shoreline Workshop as a * Member of The Gull Lake Quality Organization ($25.00) Member The Kellogg Bird Sanctuary or or Manor House ($35.00) Non-Members ($50.00)

Special Dietary Needs: If you indicate an allergy, please specify if it's ingested or airborne. Please provide as much information as possible about your restrictions so that we can appropriately meet your needs.

Pre-Assessment

Briefly, what do you hope to learn from the workshop?:

Photo/Audio/Video Release I authorize Michigan State University to record my image and voice (or that of my minor child named here) and give Michigan State University and all persons or entities acting pursuant to MSU's permission or authority, all rights to use these recorded images. I understand that said images will be used for educational, advertising and promotional purposes in all conventional and electronic media, and any future media. I also authorize the use of any printed material in connection therewith. I understand and agree that these images and recordings may be duplicated, distributed with or without charge, and/or altered in any form or manner without future/further compensation or liability, in perpetuity.

* Please Indicate your authorization

Natural Shoreline Workshop

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Registration Information

Pre-Assessment

How did you hear about this program?

Contact Information