Challenge Course Pre-Registration Form

David Barber Challenge Course
Pre-Registration Form

Group Name:
Date of Session:
Age Range:
No. of Participants:
Choose one:	Half Day Full Day 1-night Adventure 2-night Adventure
Group Leader Name:
Address:
City:
State:
Zip:
Phone:
Fax:
e-Mail:
	Are there any issues that your group would benefit from targeting? Check those that apply:
	Communication sharing of ideas Cooperation goal setting Trust planning Dominant leaders gender roles Shared leadership Other:
List any factors prohibiting full participation by any members of the group so that we can modify the activities as needed:
What is the purpose for your group choosing to participate in the Challenge Course?
What do you as the leader hope to see accomplished?