Follow these simple steps to register for a trip:

• Call to confirm and hold your date.
• Complete the form below that includes contact information and trip requested.
• Read, print and sign the Release form.
• Submit your registration form and release form along with your payment by check or money order to:

Wilderness Outreach Adventures
652 Schiermeier Road
Freeburg, Illinois 62243
(or you can mail in the forms and call us at 618-779-4453 with your credit card information)

REGISTRATION FORM

NAME: __________________________________________________________________________

MAILING ADDRESS: ___________________________________________________________

CITY: ____________________________ STATE: ________ ZIP CODE: _____________

EMAIL ADDRESS: ______________________________________________________________

PHONE: _________________________________________________________________________

TRIP REQUESTED: ______________________________________

DATES REQUESTED: ____________________________________

BIRTHDATE: _____________________ HEIGHT: _________ WEIGHT: __________

T SHIRT SIZE: _____________________ (needed for matching boats to participants)

EMERGENCY CONTACT INFORMATION: ________________________________________

Do you have any allergies (food, medication, etc…) that we should know about?

Do you have any physical disabilities, medications, or special needs that we should know

about?

PLEASE NOTE: Your space is officially reserved upon receipt of payment for the trip.
Payments made over the phone by credit card will receive immediate confirmation.

No refunds will be made for trips cancelled less than 14 days prior to departure.

Basic Kayak Trip: $ 59.00-69.00 based on destination

Saturday Paddle $ 49.00

Intermediate Trips: $ 95.00 Church Rate -per person

3-Day Camp: $210.00 10 person minimum

Scenic Trips: $ 65.00 $35.00 camping only

Weekend Overnight: $145.00 $45.00 camp/kayak weekend

*all prices are per person. Discount applies to group leader of 4 or more.