Winter Course Participant Information Form
It is important for each participant to carefully and thoroughly complete and submit the information requested on this form at least 2 weeks prior to your course start date. This information will be kept confidential and used only by our leaders for the planning of your trip.

If you have questions please don't hesitate to contact us:
info@lostcreekadventures.org
(715) 953-2223
Email address *
Class/Workshop Title *
Your answer
Course start date *
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YYYY
Course end date *
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YYYY
Your name *
Your answer
Your mailing address *
Your answer
Phone (A cell phone you would have with you on your trip is preferable) *
Your answer
Equipment needs
The following information is for sizing equipment. Age specification is only necessary for those under 18, but helpful for planning regardless.
Age
Your answer
Height *
Your answer
Weight *
Your answer
Health History Information
Due to the remote nature of wilderness travel you will be in area with delayed access to definitive medical care. Please answer each question thoroughly, even if you think it is minor or not applicable.
Your general level of fitness. Feel free to let us know what you currently do to stay healthy and in shape. *
Your answer
Do you have any general health issues? Any issues that may come up specific to camping, cold weather, exertion, lifting, etc? *
Your answer
What prescription medications are you taking or have you been taking within the past 6 months? *
Your answer
Please describe intended use and possible side effects. (drowsiness, sun sensitivity, etc.) *
Your answer
Do you have allergic reactions to insect stings/bites? Severity of reaction? *
Your answer
Please check if you have any of the following issues or concerns
Please provide details regarding any checked items.
Your answer
Meal Preferences
We strive to prepare high quality, tasty and nutritious meals. Though we can't always cater to exact desires, your guide will prepare the menu with your preferences in mind. Please be sure to give full details of food allergies and potential physical reactions.
Do you have any specific food allergies? Please describe. *
Your answer
What are some of your favorite foods? *
Your answer
What are some of your LEAST favorite foods? *
Your answer
Describe your appetite (For example, do you eat a lot for breakfast or none at all? Snack a lot?) *
Your answer
Drink Preferences *
Required
Feel free to add to or describe your drink preferences.
Your answer
A bit more about you...
To better help us plan your trip please share some of your goals and expectations for your trip. Why are you coming? What do you hope to get out of it? Is there anything in particular that you most want to see or experience? What do you expect from your guide? Your group members?
What is your camping experience? Winter experience? *
Your answer
How familiar are you with the topics that this course will cover? *
Other questions or comments?
Your answer
A copy of your responses will be emailed to the address you provided.
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