Cobia Overnight - Special Payments Form | Wisconsin Maritime Museum

Use this form to add additional participants after you've paid the final balance. All new participants must be approved by the Overnight Coordinator.

Date of Overnight Stay*
MM slash DD slash YYYY
Group Name*
Primary Contact*
First Last
Phone*
Email*
Number of additional participants Quantity
Price: $50.00
Total
$0.00
This page is unsecured. Do not enter a real credit card number! Use this field only for testing purposes.
Credit Card*
Card Details
Cardholder Name
Names of additional attendees*
Name Youth or Adult

First and last name for each additional participant
Comments
This field is for validation purposes and should be left unchanged.

Name	Youth or Adult