Blackwater Outdoor Experiences Online Application
Thank you for your interest in Blackwater Outdoor Experiences. The following document is our Admissions Application and it is our primary tool used in preparing to best meet the needs of an Applicant for a Blackwater Therapeutic Expedition. We ask that you take the time to thoughtfully respond to each question. The more in depth and thorough your answers, the more effectively we can work with your family. Feel free to attach an additional sheet of paper if more space is needed.

ALL information (aside from the Physical Examination) requested in this application must be submitted before a final consideration will be made. If parents/guardians are divorced or separated, it is beneficial to us for both parents/guardians to complete the “Family History” section. If Applicant has participated in any psychological/educational testing, please provide a copy of available documentation and results for us to review.

Please download a paper copy of the application to sign the final signature forms from


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Email address
Full Name of Applicant (First Name, Last Name)
Date of Birth
Address (City, State, ZIP)
Student Phone Number
Student Email
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