Team Trip Payment Form
First Name
*
Last Name
*
Street Address
*
City, State, Zip
*
Your Email Address
*
Date of Trip
*
Group/Church Name
Group Leader Name
Each Additional Team Member- If you are paying for more than one person please include Names in Comments Box.
*
N/A
Second Person (Add $200.00)
Third Person (Add $400.00)
Fourth Person (Add $600.00)
Fifth Person (Add $800.00)
Sixth Person (Add $1,000.00)
Seventh Person (Add $1,200.00)
Eight Person (Add $1,400.00)
Ninth Person (Add $1,600.00)
Tenth Person (Add $1,800.00)
Has Everyone Completed the Online Waiver Form?
*
No
Yes
Question/Comments
Base Price
$
Modifications
$
Total
$
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