Oh The Places We Will Go! Application Form
Please complete the following registration as thoroughly as possible as it helps us determine goodness of fit and ensures we are meeting the needs of those who join our Specialty Modules. If you are an existing member you do not need to fill out this form, instead, please reach out to Rebecca Sousa rrsousa@3lplace.org.

Who should apply:

  • Programming is open to participants 18+ who are able to maintain safety in a community setting.
  • Participants who would do well with 3:1 staffing ratios
  • Participants who love adventures, experiences, and exploring!

Enrollment:

  • A schedule of adventures will be shared in advance, for the upcoming month. 
  • If there are not sufficient participants for a given adventure, we will notify you in advance and will refund/credit for the date.  
  • The schedule will be subject to change as needed due to weather and or health concerns.
  • Programming will run from 10am-4pm on Mondays.
  • There will be no make up for absences. Absences will not be refunded as staffing and event ticket purchases will have been made based on confirmed participation.
  • Daily cost: $270
  • 3LPlace will determine is participant if suitable for the adventure programming.
  • A waitlist will be created for attending if interest exceeded availability.
Questions regarding registration?
Please email Rebecca Sousa, rrsousa@3lplace.org

*Form is best completed on a Laptop/Desktop and not a mobile device. You will receive a copy of this form upon completion.

**Completion of this form does not guarantee enrollment

 
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Email *
How did you hear about this 3LPlace opportunity? *
Name of Participant *
Participant's Phone Number *
Participant's Email Address *
Name of Person Completing the Form *
Phone Number of Person Completing the Form *
Who will be the contact person/responsible party? *
Address: Street, City, State, Zip
*
Is the participant is a current member of 3LPlace *
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