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* 1. Name of Group 

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* 2. Contact Person 

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* 3. Email Address

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* 4. Telephone Number 

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* 5. Number of Participants

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* 6. Age Range of Participants

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* 7. Number of Chaperones

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* 8. Number of Chaperones That Will Participate 

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* 9. Desired Activity (Please Select All That Apply) 

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* 10. Desired Location 

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* 11. Desired Event Format

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* 12. Mailing Address

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* 13. City, State and Zip Code 

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* 14. Preferred Dates (Please include multiple options)

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* 15. Top Four Objectives. (e.g. fun, team building, wilderness skills, etc.)

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* 16. Describe your group. How long have they known each other and in what capacity?

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* 17. Are there any group issues or challenges that you would like to address during the event?
 

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* 18. Do you foresee any physical or emotional limitations for anyone in this group that we should take into consideration when planning your event?

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* 19. Please list any additional questions or concerns.

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* 20. Has your group participated in a Cal Adventures custom event before? If so, are there any specific activities that you would/would not like to repeat?

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* 21. How did you hear about our program?

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