Participant Information

Participant Information (Group Climbing)

"*" indicates required fields

Type of Program*

First Name*

Last Name*

Preferred Pronouns*

Cell Phone Number*

Email Address*

Group Name*

Type of Group*

Size of Group*

Ages*

Accurate sizing of gear is important for the comfort and safety of participants. Does anyone in your group have specific sizing requirements?*

If yes, please explain.

Do you have medical information for each of the participants?*

Do any of your participants have allergies (bees, food, plants, other)?*

If yes, please explain.

Do any of your participants require an Epi-Pen? If yes, they must bring it with them.*

Do any of your participants require an inhaler? If yes, they must bring it with them.*

Are there any other health conditions that we should know about?

Describe the goals for your group. Are there any curricular elements that you would like us to tie into your program?*

I have read and understood all of the above questions and answered them truthfully.*

I agree.

Name

This field is for validation purposes and should be left unchanged.