Adult Winter Program Registration Form

Select Program *
Use this form to register your place on a program. Once we have received your payment we consider your spot reserved and will hold it for you. Once you submit your form we will email you a specific winter program information pack. The CareMonkey system will generate medical and permission forms for you to complete online. We do not offer refunds less than 6 weeks prior to the program, so please consider carefully prior to making a booking. If you have any questions regarding the bookings form or procedure you can email Alli (Bookings & Communications Manager) at info@mittagundi.org.au. Claire will usually get back to you within 2 business days.
Participant Name *
Participant Name
Home Address
Home Address
Date of Birth *
Date of Birth
Transport *
Payment Option *
If sending a cheque, please post to: Mittagundi Outdoor Education Centre 4385 Omeo Highway Glen Valley VIC 3898 (Include note stating Participant's Name and Program Number e.g. Stu Clark, Adult Winter)