Application Form - Go Wild Summer Adventure

How do I apply for the Go Wild – Summer Adventure?

Fill out this online application form
Download the Medical Information, Waiver &Photo release form, Program Description, Equipment List and Parent Information Letter.
Complete the Medical Information, Waiver, & Photo release form and mail with a $50 deposit within 2 weeks of completing the online application to:
Wildsight - Go Wild
2 - 495 Wallinger Avenue
Kimberley BC V1A 1Z6

Cheques can be made payable to Wildsight, or phone the office weekday mornings to pay by credit card.
Read the Program Description and Equipment List and pass on the Parent Information Letter to a parent /guardian.

Payment in full must be received 2 weeks prior to the trip start date.

Subsidies are available for participants, please contact Wildsight for information.
For more information or questions please contact Wildsight at or office@wildsight.ca

Personal Information

Name: *

Gender: *

Male

Female

Age: *

Date of Birth: *

Height: *

Weight: *

Course Selection

Desired Date: *

Contact Information

Email: *

Home Phone:

Cell Phone:

Address:

Parent or Guardian Information

Relationship: *

Address: *

Name: *

Day Phone:

Evening Phone:

Cell Phone:

Email:

Emergency Contact: If different from above

Name:

Relationship:

Address:

Day Phone:

Evening Phone:

Cell Phone:

Education

Current or last school attended: *

Grade/Level completed: *

Currently Employed?: *

Yes

Employer:

Have you participated on a Go Wild trip before?: *

Yes

If yes which trip?:

Additional Information

We would like to know a little bit about you.

Please explain why you are interested in participating in a Go Wild trip: *

What is your greatest success in the last six months?: *

A Go Wild trip requires a large amount of commitment. Can you describe something you have made a major commitment to?: *


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	Application Form - Go Wild Summer Adventure Tweet How do I apply for the Go Wild – Summer Adventure? Fill out this online application form Download the Medical Information, Waiver &Photo release form, Program Description, Equipment List and Parent Information Letter. Complete the Medical Information, Waiver, & Photo release form and mail with a $50 deposit within 2 weeks of completing the online application to: Wildsight - Go Wild 2 - 495 Wallinger Avenue Kimberley BC V1A 1Z6 Cheques can be made payable to Wildsight, or phone the office weekday mornings to pay by credit card. Read the Program Description and Equipment List and pass on the Parent Information Letter to a parent /guardian. Payment in full must be received 2 weeks prior to the trip start date. Subsidies are available for participants, please contact Wildsight for information. For more information or questions please contact Wildsight at or office@wildsight.ca Personal Information Name: * Gender: * Male Female Age: * Date of Birth: * Height: * Weight: * Course Selection Desired Date: * Contact Information Email: * Home Phone: Cell Phone: Address: Parent or Guardian Information Relationship: * Address: * Name: * Day Phone: Evening Phone: Cell Phone: Email: Emergency Contact: If different from above Name: Relationship: Address: Day Phone: Evening Phone: Cell Phone: Education Current or last school attended: * Grade/Level completed: * Currently Employed?: * Yes No Employer: Have you participated on a Go Wild trip before?: * Yes No If yes which trip?: Additional Information We would like to know a little bit about you. Please explain why you are interested in participating in a Go Wild trip: * What is your greatest success in the last six months?: * A Go Wild trip requires a large amount of commitment. Can you describe something you have made a major commitment to?: *

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Application Form - Go Wild Summer Adventure

How do I apply for the Go Wild – Summer Adventure?