Youth Custom Course Sign Up
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Group/ School Name *
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Group / School Website (N/A if you don't have one) *
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Representative First Name *
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Representative Last Name *
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Representative Email *
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Representative Phone *
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Representative Mailing Address *
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Approximate Group Size *
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Age of Participants (Note: We generally do not provide on-water activities for students under 10. We can do land and water-related activities for all ages.) *
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Format *
Theme (Select all that apply) *
Required
What are the goals of your Custom Course? What do you hope participants get out of the event/course? *
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Preferred Date (or Start Date for Multiple Session) *
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DD
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YYYY
Preferred Time of Day - Be as specific as you can (e.g. 2-6pm, evening) *
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Date Range (If you do not have an exact date)
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Location Preference *
Required
Do a majority of the participants qualify for free or reduced lunch (Title 1)? *
Special Requests for Event or Other Comments
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