Important to Read:

Please note that completing this form does not secure your spot on a trip.  Once you have completed the following, you must go to antiochfc.org/give and find the payment option for Wilderness Trip Deposits.  Upon paying the non-refundable $50 deposit and the completion of this form, your spot will be secured.  For questions, email info@antiochfc.org

* 1. Name:

* 2. Phone:

* 3. Email:

* 4. Which trip will you be attending?

* 5. What is your DOB?

* 6. Do you think you will need to rent trip gear (i.e. pack, sleeping bag, etc)?

* 7. Do you have any food allergies? (please list)

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