Workshop Registration
You have found the registration form for the Women's Basic Survival Skills Workshop! The workshop is for women ages 12 -
100 who are interested in learning basic wilderness survival skills. It will take place on August 15 from 9 am - 7 pm near Bemidji, MN. The cost is $75. Dinner over the fire will be provided.

Complete registration by returning to the website: appleblossomccc.com to pay via PayPal, or by sending checks to: Dacia Dauner 7596 Miltona Dr SW Bemidji, MN 56601

After registration is complete, you will receive a confirmation email with workshop details.

Email address *
Participant's Name
Your answer
Participant's Date of Birth
MM
/
DD
/
YYYY
Parent/Guardian name(s) if the participant is under 18.
Your answer
Primary phone
Your answer
Primary physician
Your answer
Physician's phone
Your answer
Name and phone of persons to be notified in case of emergency.
Your answer
Does the participant have any special dietary needs?
If yes, please describe.
Your answer
Does the participant have any relevant medical needs?
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms