Big Dig 2017 Registration
Billings Chapter GPAA
P.O. Box 21247
Billings, MT 59104
May 27-29, 2017
This Form is to be used when No SHIRTS are being ordered.
Everyone is responsible for themselves.

The Billings Chapter GPAA or its Officers WILL NOT Be held responsible for any injuries that may incur during the event.

I have read the above statement and agree to the terms set forth.
By placing you name in the above box, it constitutes your signature and agreement to the terms.
Name::
Address:
Phone Number:
Names of Persons Attending / Digging
Where are you Staying?
Vehicle: 
Make, 
Model 
Color, 
Plate
Any Medical Condition we need to know about?
Emergency Contact Name & Phone Number
Do you have Medical Experience?
If YES, What Type?
What shift would you prefer to work?
Work With?
Name of Person Agreeing
Agreement
Were Glad Your are going to Join US in Zortman, Montana