MidWinter Advance Sign-Up

IMG_1479.jpg
 
 

Yes! Please sign me up for
Midwinter Advance

Dates: January 25-27, 2019
Cost: $130
Deposit:  $45 due by December 1

Name *
Name
Emergency Contact Name
Emergency Contact Name
Emergency Contact Phone *
Emergency Contact Phone
Please share any concerns or information that we should be aware of including medical conditions, allergies, or medications.
MUMC Release Form *
MWA Participant Form *