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UW-Madison Lakeshore Nature Preserve
Geocache Permit Request Form
(July 10, 2009)
Instructions: Read and understand the Geocache policy.
Send us your information any of these ways: Send to: email@example.com
A permit is valid for 12 months from the date approved. After that date, the cache must be moved and a new location permitissued or the cache must be removed from the premises.
Cache Owner Information:
Phone number ____________________________________________
E-mail address ____________________________________________
Cache name as listed on geocaching.com:_______________________
Physical description of container_______________________________
Location coordinates ______________________________________
Physical description of area_________________________________
I hereby request permission to place a geocache on lands managed by the Lakeshore Nature Preserve. I agree to comply with the provisions of Preserve policy on geocaching. I understand that I am to monitor this cache quarterly and maintain it in a safe and secure manner. I understand that caches not in compliance with the terms of this permit will be removed from the property and this permit will be voided.
Name of Applicant____________________________________
Permit approved by __________________________________
Permit expiration date_________________________________
Permit denied by ____________________________________
Reason for denial____________________________________