Registration For Wilderness Workshop

DATE: ____________

NAME: ______________________________________________

ADDRESS:_____________________________________________

CITY: ______________________________STATE: ____________

CONTACT PHONE NUMBER: _______________________________________________________

E-MAIL ADDRESS: ________________________________________________________________

What are you wanting out of this workshop? 

Payment must be paid in full prior to registration:

$350.00 per person 

Mail in Coyote Mule Co. 194 Twin House Rd. Cottonwood, ID 83522