Walkabout Registration Form
Please enter the following information to register. Required fields
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Title:
Mr
Miss
Mrs
Ms
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Name:
Organization:
Position:
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Address:
Address2:
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City:
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State/Province:
N/A
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AB
AE
AK
AL
AP
AR
AZ
BC
CA
CO
CT
DC
DE
FL
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MI
MN
MO
MS
MT
NB
NC
ND
NE
NF
NH
NJ
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
QC
RI
SC
SD
SK
TN
TX
UT
VA
VT
YT
WA
WI
WV
WY
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Country:
USA
Canada
Germany
Japan
Mexico
UK
Other
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Zip/Postal Code:
Phones:
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Business
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Evening
Cell
Emergency:
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Name
*
Phone
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Email:
Website/Blog:
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Lodging:
I will reserve local lodging
I want onsite camping
I want to reserve the Ojo Cabin
Eating Restrictions:
None
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Program:
5-day group walkabout $875
Customized group walkabout $950
Personal walkabout fee to be determined
No Applicable Discount
Return for another walkabout - 25% discount
Early bird registration - 10% discount
Refer another participant - 10% discount
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Payment:
Credit Card via PayPal
Check or Money Order
Other Arrangement
Comments or Questions:
None
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Enter: LItpfH
Fees and Method of Payment – We accept check, money order or credit card. If you would like to pay by credit card you can do so through PayPal. We will send you a "PayPal Request for Payment" after receiving your completed registration. Please note there is a 3% surcharge for this convenience. We are not able to offer direct online payments at this time.