GV Challenge Course Needs Assessment
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Organization
Main Contact Name
Main Contact Phone Number
Number of Participants
Program date or range of potential dates
Objectives - Pick your TOP 3 ONLY                   Most objectives will be fulfilled but this gives us a main focus to customize a program for you.
How long of a program would you like to schedule? Exact times can be worked out.
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Group's experience on the course
No one in the group has ever been on the course
All or most have participated on the course before
Clear selection
Tell us about your group so that we have an understanding of how to better serve you and meet the groups needs.
Are there any special needs of the group?  Physical or mental disabilities, health issues or anything we would need to know?
Although personal, these are important for us to know when putting your group through a stressful situation to keep everyone safe. You will see this question multiple times and participants will have the opportunity to disclose this information privately.
Here is our waiver that each participant, teacher and adult that will be on the property must bring with them on program day.
Please make sure to email me (Ari Philipson) to notify that you have completed this form. I will contact our facilitators and notify you with availability based on your need. 
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A copy of your responses will be emailed to the address you provided.
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