To Enroll First Name*Last Name*Address* City*State*Zip*Main Phone*Alt PhoneEmail* Birthdate & Year*Referred byI will be paying by*CheckCredit CardSend Checks to: The Bonding Weekend We will email you the address.Card TypeVisaMastercardAMEXDiscoverCredit Card #Name on CardExp. DateI wish to pay:*$250 Non-refundable deposit$825Other $*You will need to arrange your own food & sleeping accommodations.Some food may be served on site. Request Payment Plan Comments/Requests