Application for Golden Age Pass

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MARYLAND DEPARTMENT OF NATURAL RESOURCES
Maryland Park Service
580 Taylor Avenue, E-3
Annapolis, MD 21401
Attn: Golden Age Pass Application
(410) 260-8186

GOLDEN AGE PASS APPLICATION

Date: __________________ Pass Number (office use only):___________________________

NAME _________________________________________ BIRTH DATE ___________________

ADDRESS ______________________________________________________________________________

(Street Address)

______________________________________________________________________________

(City) (State) (Zip)

TELEPHONE NUMBER _____________________________________

PLEASE ATTACH A COPY OF ONE OF THE FOLLOWING LEGAL DOCUMENTS:

DRIVER'S LICENSE ________________________________

BIRTH CERTIFICATE _______________________________

OTHER PROOF OF AGE _____________________________

__________________________________________
Signature of Applicant

__________________________________________
Signature of MPS Representative

To be eligible for a Golden Age Pass, you must be 62 years of age or older.The Golden Age Pass is a free, lifetime pass for those State Park services and facilities identified below.

The Golden Age Pass is good for free entry (cardholders only) into all State Parks that have service charges to enter. NOTE: Some areas utilize coin-operated gates during the off season that cannot be opened with this card.

This pass is valid for half price camping, Sunday through Thursday (excluding holidays), but cannot be used for rentals or other facility use service charges that may apply.

Revised 5/06

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