Challenge Course Assessment Form

Group/Organization

Leader's Name

Address

Address Line 2

City

State / Province / Region

ZIP / Postal Code

Country

Phone

Email

Date of Event

Program Length

Who is the Group?

What is the age range of the participants?

What is the male to female ratio?

How many participants?

Have any of them ever been to a Challenge Course?

Yes

No

What are the leader's goals for the program?

What are the participants' goals for the program?

Are there any physical or health considerations to keep in mind?

Has the group received the ropes course release form from the office?

Yes

No

If this is a full day program, what will the group do for lunch?

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