HHR - Form - Short - Hayner Home

Hayner Hits the Road

Registration Form

Day Trip

Each individual person registering for a Hayner Hits the Road trip should fill out this registration form and agree to our "Release of Liability" on the next page.

After you fill out this form, you will be directed to our "Release of Liability" form. Then you will be directed to our secure payment system. Payment in full is required per person, per trip to complete your registration. Checks may be made payable to "Hayner Trips." However registration is not complete until a deposit is received. Your seat will be confirmed via email within three business days upon receipt of completed registration and deposit.

You may mail checks to:

Troy-Hayner Cultural Center Attn: Hayner Trips

301 W. Main St.; Troy, Ohio 45373

First we need some information about the trip you are interested in.

*Indicates a required field.

Which Trip are you registering for with this application? *

How are you planning to make your payment? *

Online (you will be directed there when you hit the submit button.)

I will mail a check

I will stop in the Hayner and make a payment.

If you are paying by credit card, what is the name on the credit card? *

Next we need to know a bit about you.

*Indicates a required field.

Your Name *

Best Phone Number *

Additional Number

Address *

Now we need for you to provide information about someone who is not traveling with you that can be your emergency contact. *Indicates a required field.

Emergency Contact Name *

Emergency Contact Best Phone Number *

Emergency Contact Additional Number

When you hit the "SUBMIT" button you will be directed to a "Release of Liability" form and then to our online payment system for you to use if you wish to pay with a credit card.