Self- & Virtually-Hosted Team Building Activity Order Form (CanadaWeb)

Company Name*

Do you have an Outback rep?

Outback rep's name

Your Name*

First NameLast Name

Phone Number*

Daytime

Your E-mail*

Please double-check to ensure it's correct

Your Activity*

Activity Date*

Activity Start Time (approx, if known)

Activity End Time (approx, if known)

Activity Time Zone (if determined)

Billing Province*

# of Participants*

Estimated group size

Group Price

Plus Tax

GST/HST

Total Payment Due*

CAD

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Is there anything more you would like us to know about your group, date or time?

By submitting payment below, you agree to the following terms & conditions of your order:

Program Confirmation Details:

100% program cost payable immediately to secure program.
All orders are subject to confirmation pending information provided.
All orders are non-refundable.

The Fine Print

You understand and acknowledge, on behalf of your group, the risks associated with participating in this event.

Next Steps

An Outback Team Building & Training representative will be in touch shortly to provide you with everything you'll need to ensure a fantastic activity for you group. We're here to help!

If you have any issues with this order form or payment, please contact us at 1-800-565-8735 or supportteam@outbackteambuilding.com.

Self-Hosted*

Discount Code

Have you decided on a date and start time?*

YESNo

Activity Format*

Virtually-Hosted Regular

Virtually-Hosted

Activity Format*

Self-Hosted ExpressSelf-Hosted RegularVirtually-Hosted Regular

Deal Name

Form Type

Deal Date

Date

Total Price

Salesforce Start

Salesforce End

Salesforce Format

Salesforce Activity

Pre-ProductX

Price Per Person

Minimum Express SH $

Minimum Regular SH $

Minimum Virtual $

Total Price (Hidden)

RepEmail

example@example.com

Salesforce Product

Salesforce Objective

Team Building Order Form