Appalachian Rites of Passage Registration Form

Appalachian Rites of Passage Registration Form

Please fill in the form below. Early Bird Registration if paid in full by Jun 21.
Adult's Name*

PrefixFirst NameLast Name
Date of Birth*

MonthDayYear
Date
Number of people in your group*
2.) Adult's Name

PrefixFirst NameLast Name
Date of Birth

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
E-mail*
Special Comments or Questions?
1.) Child's Name

First NameLast Name
Date of Birth

MonthDayYear
Date
2.) Child's Name

First NameLast Name
Date of Birth

MonthDayYear
Date
3.) Child's Name

First NameLast Name
Date of Birth

MonthDayYear
Date
4.) Child's Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Registration Fees
prevnext( X )
Parent Registration Fee (Early Bird before June 21)$300.00

Quantity

Parent Registration Fee (after June 21)$350.00

Quantity

Children/Teens Registration Fee$100.00

Quantity

Camping Fee/Night/Person$10.00

Quantity

Apprentice Registration Fee (Early Bird before June 21) $255.00

Quantity

Apprentice Registration Fee (after June 21)$297.00

Quantity

Deposit$150.00

Total $0.00
Paypal: paypal.me/spiritcanoelodge.

Checks mail to: Spirit Canoe Lodge, PO Box 111, Warrensville, NC 28693
***Please contact Kelly separately for Cabin Lodging availabilty and needs at SpiritCanoeLodge@gmail.com or call (336) 385-6312.
Cancellation Policy: Many details are planned for based on the number of participants attending. You must notify us 7 days before the event for full refund. $150 fee applies for cancellations after July 31, 2018.
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