Lifesong Wilderness  Adventures  &  Registration & Check Payment Form   

          

Select the program below BEFORE printing
Print 2 copies
- one for us and one for your records
Complete the form, sign and date it.
Mail the signed form with payment to:

Mark Wienert, Jr.

73569 Hwy 101

North Bend, OR  97459

 

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Participant's
Names and ages
    
                                                                                                                     
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Address 2                                                                                                                         
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Home phone                                                                                                                         
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Emergency Contact                                                                                                                         
Emergency Contact Phone                                                                                                                         
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Payment    Pay Course in Full                    

Payment Policy:  All Camp tuition is due 15 days prior to the first day of camp.  To insure and hold a reservation for your camp date and location, we suggest you register as early as possible. If you miss the deadline and wish to inquire about camp availability please contact us.  Prices are subject to change without prior notice and are guaranteed at the time your tuition is accepted.

 

Cancellation Policy:   All camp tuition fees are non-refundable. However, we are happy to apply the tuition for camps one year from the date of registration towards another camp, minus a $100 cancellation fee.  NO refunds or transfer of tuition fees for Custom Camps can be given. Participants who are required to leave a camp, for any reason after it has begun, will not be entitled to a refund.  Mark Wienert, Jr., reserves the right to cancel any camp, at any time, for any reason.  In this case a full refund will be given.  Lifesong Wilderness Adventures is not responsible for airfare or any other transportation cost incurred by a student whether or not a camp is cancelled.

 

Discount Policy:  Any applicable discounts will be credited to you at the end of each course completed.

 

Substance Abuse Policy:  Lifesong does not permit the use of alcohol or illegal drugs at its camps

My signature below indicates my acceptance of the terms of this agreement and my desire to participate in the programs offered by Lifesong Wilderness Adventures.
 

SIGNATURE                                                                                                       DATE