By Our Bootstraps:

A Benefit Hike Celebrating Over 10 years of New Haven Inner City Outings

Participant Registration Form

NAME: ________________________________________________

ADDRESS: _____________________________________________

______________________________________________

PHONE #: ______________________________________________

EMAIL: ________________________________________________

How did you learn of this event? ____________________________

________________________________________________________

Would you like to receive more information on becoming an ICO volunteer? ______________________________________________

I am unable to participate in this event, but would like to make a contribution to New Haven ICO in the amount of $ ____________

Please return this registration form, along with your Sponsor Information Sheet to:

New Haven Inner City Outings

c/o 103 Carmalt Road

Hamden, CT 06517

Thank you for your participation!