Registration

Child's Name*

FirstLast

Child's Name

FirstLast

Parent's Name*

FirstLast

Address*

Street AddressAddress Line 2CityStateZip Code

Parent's Email*

Phone*

This information is needed if a class is ever rescheduled or cancelled.

Cabela's Location: select date and time

Located at 9380 W. Glendale Avenue, at the 101 Loop and Glendale exit. Call 623-872-6700 for specific directions from your location.

Bring a buddy

List name of buddy. Discount will be confirmed when buddy's registration is received.

Add a class t-shirt, "Wilderness Survival Expert".

Shirts will be available for pick-up the day of the class.

Payment options

Make checks payable to Lisa Bedford and mail to: The Survival Mom, 7558 W. Thunderbird Rd., Suite 1, PMB #188, Peoria, AZ, 85381.

Additional information I should know about your child (allergies, special considerations, etc.)