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ORGANIZATION OR GROUP
Organization or Group Requesting Program *
ORGANIZER CONTACT INFORMATION
First Name *
Last Name *
Phone *
Email *
PARTICIPANT INFORMATION
Average Age of Participants *
No. of Program Participants *
What level of activity would your group prefer? * Easy (slow walking, little or no incline, gentle outdoor challenges and games)Moderate (walking, hiking at a steady pace, gentle hills)Vigorous (Team sports, dancing, 4 km plus hikes/snowshoeing, steep hills)
SELECT YOUR ADULT/FAMILY EDUCATION PROGRAM
Program/Topic --Interpretive Nature WalkInterpretive Nature Walk - With Nature Journal Add-OnBackpacking 101Intro To Outdoor SurvivalHike or Snowshoe ExperienceTeam Building Experience
Date Requested *
Alternate Date *
Note: It is recommended that booking requests are made months in advance due to high demand.
Arrival Time *
Departure Time *
Program Location/Facility * ClassroomWilley West CampgroundPembina Nordic CentreRotary/Pembina Community TrailsOther - Please Specify
Will there be adults with First Aid Certification present? * YesNo
Will there be any participants with medical conditions (i.e. Allergies, disabilities, asthma etc). Please elaborate *
Other Comments?
I agree to the terms and conditions stated above and in the “Key Messages for Organizations and Groups”. I understand that transportation to/from locations is the responsibility of the organizers unless otherwise agreed to by both parties. * YesNo
Disclaimer: Transportation will NOT be provided. It is up to the organizers to coordinate this service.
ORGANIZATION OR GROUP LEADER AUTHORIZATION
Date *
MAILING ADDRESS
Eagle Point – Blue Rapids Parks Council #5136 51 Ave Drayton Valley, AB T7A 1S5
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