State of New

JerseyD

epartment of E

nvironmental Protection

Division of Parks and Forestry

New

Jersey State Park ServiceM

ail Code 501-04 P.O

. Box 420Trenton, N

ew Jersey 08625-0420

DEPARTMENT OF EN

VIR

ON

MEN

TAL PROTECTIO

N

DEPARTMENT OF EN

VIR

ON

MEN

TAL PROTECTIO

N

NEW

JE

RS

EY

DIVISION OF PARKS

STATE PARK

SERVICE

AND

FORESTRY

N. J.Explore

New Jersey’s State Parks & Forests

Qualification • Age 62 or older.

Benefits • Provides free entrance to all state park, forest, recreation area and historic site facilities that charge daily walk-in or parking fees, as well as a $2 per night discount on campsite fees (excluding group campsites). • The senior citizen pass is valid for your lifetime.

How to ApplyTo obtain a senior citizen pass, either visit any park office or mail the completed application on reverse side with supporting documentation.

NOTE: A pass does not guarantee entry when facilities are filled to capacity or closed. A pass cannot be used for group visits and is not valid for buses or commercial or group transportation vehicles. All groups must make reservations in advance through the area office and applicable bus fees may apply. Disabled persons and senior citizen groups should contact the park office for applicable fees.

Open Public Records Act (OPRA) NJSA 47:1A-1Information provided on this application may be subject to review and inspection under the Open Public Records Act (OPRA) NJSA 47:1A-1.

If you enjoy swimming in crisp, cool waters, hiking the Batona Trail through the Pinelands National Reserve, climbing the Appalachian Trail into the Kittatinny Mountains or touring historic sites and villages, a New Jersey park pass is for you.

New Jersey has 43 parks, forests and recreation areas as well as 57 historic sites, representing New Jersey’s natural and cultural legacy, covering more than 450,000 protected acres.

Senior Citizen Pass Disability Pass

HIGH POINT STATE PARK

BARNEGAT LIGHTHOUSE STATE PARK

Explore All ofNew Jersey’s State Parks & Forests

DEPA

RT

ME

NT O

F ENVIRONMEN

TAL P

RO

TE

CTIO

NDEPA

RT

ME

NT O

F ENVIRONMEN

TAL P

RO

TE

CTIO

N

NEW JERSEY

DIVISION

OF

PARKS

STATE

PARK

SERVICE

AND

FORESTRY

N. J.

Qualification• New Jersey residents with a disability.

Benefits• Provides free entrance to any state park, forest, recreation

area, and historic site facilities that charge daily walk-in or parking fees, as well as a $2 per night discount on campsite fees (excluding group campsites). Many areas and facilities are accessible to persons with disabilities. If you require special accommodations, it is recommended that you contact the area office prior to your visit.

• The disability pass is valid for the term of your disability.

How to ApplyTo obtain a disability pass, mail the completed application on reverse side with supporting documentation.

Application for a free

Senior Citizen or Disability

park Pass

Senior Citizen Pass

Please check off and attach a copy of one verification document.

Age/New Jersey residency verification documents

Valid driver’s license Government issued ID

Disability Pass

Please check off and attach a copy of one disability verification document AND one copy of a New Jersey residency verification document.

Disability verification documents Social Security Certificate of Disability

(Certification of Disability Determination) Supplemental Security Income (SSI)

(Notice of Decision Certificate for Total Disability) Certification by the New Jersey Commission for

the Blind verifying the individual is blind. Medical certification signed by a licensed,

practicing physician. (on next panel)ANDNew Jersey residency verification documents

Valid driver’s license Government issued ID

Allaire State Park4265 Atlantic AvenueFarmingdale, N.J. 07727(732) 938-2371

Atsion Recreation Area744 Route 206Shamong, N.J. 08088(609) 268-0444

Barnegat Lighthouse State ParkBroadway and the BayBarnegat Light, N.J. 08006(609) 494-2016

Bass River State Forest762 Stage Road Tuckerton, N.J. 08087(609) 296-1114

Belleplain State Forest1 Henkin-Sifkin Road Woodbine, N.J. 08270(609) 861-2404

Brendan T. Byrne State ForestRoute 72 East, Milepost 1New Lisbon, N.J. 08064(609) 726-1191

Cape May Point State ParkLighthouse AvenueCape May Point, N.J. 08212(609) 884-2159

Cheesequake State Park300 Gordon RoadMatawan, N.J. 07747(732) 566-2161

Delaware & Raritan Canal State Park145 Mapleton RoadPrinceton, N.J. 08528(609) 924-6507

Bull’s IslandRecreation Area2185 Daniel Bray Highway(Route 29)Stockton, N.J. 08559(609) 397-2949

Forked River State Marina311 South Main StreetForked River, N.J. 08731(609) 693-5045

Fort Mott State Park454 Fort Mott RoadPennsville, N.J. 08070(856) 935-3218

Hacklebarney State Parkc/o Spruce Run Recreation AreaHigh Point State Park1480 State Route 23Susssex, N.J. 07461-3605(973) 875-4800

Hopatcong State ParkP.O. Box 8519Landing, N.J. 07850(973) 398-7010

Island Beach State Park2401 Central Ave P.O. Box 37Seaside Park, NJ 08752(732) 793-0506

Jenny Jump State Forest330 State Park RoadHope, N.J. 07844(908) 459-4366

Kittatinny Valley State Park199 Goodale RoadNewton, N.J. 07860(973) 786-6445

Leonardo State Marina102 Concord AvenueLeonardo, N.J. 07737(732) 291-1333

Liberty State Park200 Morris Pesin DriveJersey City, N.J. 07305(201) 915-3400

Monmouth Battlefield State Park347 Freehold- Englishtown Road Manalapan, N.J. 07726(732) 462-9616

Parvin State Park701 Almond RoadPittsgrove, N.J. 08318-3928(856) 358-8616

Ringwood State Park1304 Sloatsburg RoadRingwood, N.J. 07456-1799(973) 962-7031

Round Valley Recreation Area1220 Lebanon/ Stanton RoadLebanon, N.J. 08833-3115(908) 236-6355

Spruce Run Recreation Area68 Van Syckel’s RoadClinton, N.J. 08809(908) 638-8572

Stephens State Park800 Willow Grove StreetHackettstown, N.J. 07840(908) 852-3790

Stokes State Forest1 Coursen RoadBranchville, N.J. 07826(973) 948-3820

Swartswood State Park1091 County Route 619Swartswood, N.J. 07877(973) 383-5230

Voorhees State Parkc/o Spruce Run Recreation Area251 County Road 513Glen Gardner, N.J. 08826(908) 638-6969

Washington Crossing State Park355 Washington Crossing Pennington RoadTitusville, N.J. 08560-1517(609) 737-0623

Waterloo Village Historic Site525 Waterloo Road Stanhope, NJ 07874 (973) 347-1835

Wawayanda State Park885 Warwick TurnpikeHewitt, N.J. 07421(973) 853-4462

Wharton State Forest 31 Batsto RoadHammonton, N.J. 08037(609) 561-0024

Worthington State ForestOld Mine RoadColumbia, N.J. 07832(908) 841-9575

Name _______________________________________

Address _____________________________________

City________________State ____ Zipcode ________

Telephone ___________________________________

email _______________________________________

APPLICATION FORM Senior Citizen or Disability Pass

Disability Pass Medical Certification FormThe following information is required to verify the applicant’s request for a free New Jersey State Park Service Disability Pass. A disabled person is defined as a person with a physical or mental impairment that substantially limits one or more of the major life activities. This means the individual is limited in his or her ability to perform such functions as caring for oneself, executing manual tasks, walking, seeing, hearing, speaking, breathing, learning or working.

Applicant’s name ______________________________

Applicant’s address ____________________________

_____________________________________________

1. Please check the extent to which you believe the applicant will be or is disabled.

Permanently TemporarilyIf temporarily, please indicate the approximate date when the applicant in your opinion, would no longer be disabled.

_________Month _________Year

2. I last examined the applicant on _________day of _________ 20____.

_____________________________________________Physician’s original signature Date(STAMP NOT ACCEPTED)

Doctor’s name (please print)____________________________________________

Doctor’s address ______________________________

____________________________________________

Doctor’s telephone number _____________________

MAIL THIS APPLICATION TO:New Jersey State Park Service Mail Code: 501-04P.O. Box 420Trenton, New Jersey 08625-0420

NEW JERSEY STATE PARKS & FORESTS TO VISIT