NAME: _______________________________________________________________

LOCAL ADDRESS: _____________________________________________________

LOCAL TELEPHONE: __________________________________________________

E-MAIL:_______________________________________________________________

PAYMENT: [   ] $150 trip fee in the form of CASH (preferred) or by check payable to:
"NDSU GEOSCIENCES DEPARTMENT".

In registering for this course, I agree to the following:

1. I agree to represent North Dakota State University in a responsible manner.

2. I understand that the fee is NON-REFUNDABLE except in the event of the development of a course waiting list.

3. My registration for this trip may not be transferred to another individual except by permission of the instructor.

4. I carry my own medical insurance coverage.

   I have read and agree to comply to the alcoholic beverage policy.