|
Print out and mail this registration blank for 2008. Potawatomi Trail of Death Assn. Fulton County Historical Society, 37 E 375 N, Rochester IN 46975 Phone 574-223-4436 I plan to travel with the Trail of Death caravan on the following days (circle dates).
Name __________________________________________________________________
I am enclosing $20 per person or $30 per family (all living in one household) who will be traveling on the caravan. This is to help cover postage and expenses to set this trip up. Amount enclosed: $ ________________ Make check to PTDA, c/o Fulton Co. Hist. Soc., 37 E 375 N, Rochester, IN 46975. I give my permission for FCHS to use any pictures of me and my outfit on the FCHS and PTDA web pages or to be published in newspapers and newsletters. Liability Waiver: I waive and release the Fulton County Historical Society, the Potawatomi Trail of Death Association, and its agents, representatives, committees and members from any and all claims or rights to damages for injuries or losses suffered by myself and/or members of my family, directly or indirectly while participating in the Trail of Courage Living History Festival, the Potawatomi Trail of Death Caravan, and all its activities. I alone am liable for loss, damage, or injury to myself and my property and damage to others and their property by me, my property, family and pets while on the property of the Fulton County Historical Society. Signature ___________________________________________ Date____________________ Spouse’s signature ____________________________________ Date____________________
|