46er OUTDOOR LEADERSHIP WORKSHOP

APPLICATION FOR REGISTRATION

for the 38th Annual Workshop – May 1-3, 2009

(SELECTION BEGINS MARCH 15 / ENDS APRIL 27, 2009)

(EARLY REGISTRATION ENCOURAGED!)

I wish to submit my application for enrollment for this year's annual Outdoor Leadership Workshop. My registration fee of $30.00 is enclosed.

PLEASE ENCLOSE A SEPARATE CHECK FOR EACH APPLICATION.
(Check or money order should be made payable to The Adirondack 46ers

NAME (Please print): _________________________________ DATE:_____________________

STREET: ______________________________________________________________________

CITY: ________________________________ STATE: _____________ ZIP: _______________

TELEPHONE: (_______) _______ ___________ E-MAIL: ______________________

AGE: ______ SEX: M F OCCUPATION: ____________________________

HAVE YOU PREVIOUSLY ATTENDED THE 46er OUTDOOR LEADERSHIP WORKSHOP?
YES NO

If I am accepted, I understand that I must assume all responsibility for my own safety and for my personal property, and I will not hold the Adirondack Forty-Sixers, Inc., nor any of the staff members responsible for any losses or injuries I might suffer while traveling to or from the Workshop site at Adirondack Lodge or during the Workshop session.

______________________________

(Signature of Applicant)

Applicants should also be aware that:

~ Weather conditions in early May are extremely unpredictable; some Workshops during the past thirty-four years have seen snow, freezing rain, and temperatures below freezing.

~ Meals provided during the Workshop begin with breakfast on Saturday morning and end with lunch on Sunday afternoon. Participants will have to provide their own Friday evening meals.

Mail this application, signed, along with the registration fee of $30 (payable to the Adirondack 46ers) to reach the Workshop Committee prior to March 15, 2009.

Address it to: 46er Outdoor Leadership Workshop

c/o Don McMullen, PO Box 126, Lake Placid NY 12946

[Where applicable, place checks (ü) or numbers in parentheses provided.]

I plan to use my skills with: ( ) Adults primarily

( ) Children primarily

( ) Both equally

My reasons for wanting to enroll in the Workshop (How I plan to put this training to use):

Answers to the following questions will assist the Workshop Committee and Staff in planning to meet participant needs and interests:

HIKING EXPERIENCE: ( ) Never ( ) Limited ( ) Often

( ) Day Hikes ( ) Overnight hikes ( ) Extended

( ) less than 5 miles ( ) 5-10 miles ( ) over 10 miles/day

Details:

WILDERNESS CAMPING EXPERIENCE: ( ) Never ( ) Few times ( ) Often

Brief summary:

In which of the following subjects would you like instruction?

[Rate each subject according to interest level (1-2-3-4-5) - 1 greatest to 5 least]:

( ) camping skills ( ) food planning and packing ( ) equipment selection

( ) map and compass ( ) trip planning ( ) Adirondack flora

( ) area geology ( ) first aid ( ) group leadership

( ) area history ( ) organizing a camping course ( ) stewardship

( ) other (specify):

EQUIPMENT: Can you bring with you any of the following equipment to share with others?

( ) 2-3 person tent ( ) backpacking stove ( ) pots/pans

Are you willing to share a tent? YES NO

FURTHER COMMENTS: