Baja 201 2016
Name
*
Your Email Address
*
Phone
*
Mailing Address
Student or Adult?
*
Student
Adult
Birthdate (00/00/0000)
T-shirt size
*
Adult small
Adult medium
Adult large
Adult XL
Adult XXL
Adult XXXL
Cell phone carrier
Do you have a passport?
*
No
Yes
Passport Expiration Date
How well do you speak Spanish?
*
Understand some words
Understand conversations
Can carry on a conversation
Payment
*
Full amount (recommended (Add $350.00)
Deposit (for students participating in fundraising (Add $100.00)
After submitting payment, please return to trcpella.com/baja201 for the "Baja checklist."
Total
$
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