First Name:
Last Name:
Spouse/Friend First Name:
Spouse/Friend Last Name:
Street Address:
City
State
Zip Code:
Phone Number:
E-Mail Address:

All meals and Challenge course fees are included in all price categories
Per Couple Rate - $ per person 

Requesting a Scholarship
(*Please note - if checked, Canterbury's Director of Program will contact you.)

Any special needs? (i.e. diet, physical limitations)

Payment is due upon arrival. 
We accept Cash, Checks, All Major Credit Cards.