Miles of beautiful trails through
pristine forests
Meet others that enjoy  out
door adventures too
backwoodssurvivaladventures
* Your first name :
* Last name :
* Date of birth :
* Male/Female :
* E-mail address :
* Address :
* City :
* State / Provence :
* Zip / Postal code :
* Country :
* Home phone :
* First name :
* Last name :
* Home Address :
* City :
* State / Province :   
* Zip code :  
* Country :
* Home phone :
* Work phone :
* Cell phone :
* E - mail  address :
* Relationship :
Name of event :    
Dates of event :
* Level of adventure :               
 ( easy, moderate, arduous )
* Age of participant :  
* Number of weeks :
To reserve your Adventure  choose one of    
the following :
A check will be mailed to        
Backwoods Survival Adventures for
For insurance
Or
Bill my credit card  

Enter Type of card :
IE ; master, visa etc.
* Payment amount :
* Credit card number :
* Name on card :
* Expiration date :
* Security code :
( on the back of credit card )
* Billing address :
* City :
* State :
*Zip code :
* Country :
Refer a friend and get a 5% discount on your tuition.
Click here
Note:  No refunds 10 days prior to event , tuition must be         
            payed in full prior to  event
Participation  Agreement
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* I have read and agree to the       
      enrollment terms: Type "Yes"
* Participant Type your name :
* Participant Type today's date:
* Perent/Guardian Type your name :
* Parent/Guardian Type today's date:

We respect your privacy
We do not share any information with any one without
your permission .
We will fax or mail this application to you upon request .  
Use the box below,  or fill out form and submit
Participant information
Parent / Guardian  Information :