Please fill out all fields to enroll in an open-enrollment Summit Adventure course.
Adult Name:
Age:
Minor Name:
Age:

Street/PO:

 Day Phone:
City:
Evening/Cell Phone: 
State:
Zip:
Fax:  
Country:
E-Mail:
Please put me on the Summit Adventure mailing list.
Course:
  NOTE: All fields are required
The $200 application fee is due at time of enrollment. Once you have submitted this form you will be directed to our online payment page where you can pay for the application fee with your credit card. The application fee is non-refundable and will be applied to your tuition balance. Complete Cancelation Policy

Note: You are not officially enrolled in a course until we have received this enrollment form and the $200 application fee.

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Please click on the Register button only one time.