2026 Kilimanjaro Soccer and Safari Summit
Registration Form
Name
*
Mr.
Mrs.
Prefix
First Name
Middle Name
Last Name
Address
Soccer Club
Date of Birth
Month/Day/Year
E-mail
Phone Number
Expected Traveling Roommate (if any)
Please have your Spouse or Other Traveling Roommate Register Separately
Registration Deposit
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2026 Kilimanjaro Soccer and Safari Summit Deposit
$
499.00
This payment is a non-refundable deposit for the 2026 Kilimanjaro Soccer and Safari Summit. After receiving your deposit, you will be billed $2,500, which will be due on or before December 31, 2025.
Total
$
0.00
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
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