COURSE REGISTRATION FORM

Name:
Address:
City:
State/Providence:
Zip/Postal Code:
Country:
Work Telephone:
Home Telephone:
Cell Phone:
Email Address:
Course Name:
Dates:
Course Cost/Person:
Number in Group:
Group Name:
Boot Rental For Ice Climbing
Boot Sizes Required:
Number of Boots:
Number of Days:
Have you attended our courses before?	Yes   No
Course Name
When?
Additional Information

Guidebook Orders:
Superior Ice Guidebook- $40.00 CAD
Agawa Canyon Ice Climbing Map - $20.00 CAD
North of Superior Icefest X Commemorative Poster - $25.00 CAD
Ranwick Rock Keetes Bluff Rock Climbing Guide - $20.00 CAD

Upon completion of this registration Form, Press Send