* 1. Name of Group 

* 2. Contact Person 

* 3. Email Address

* 4. Telephone Number 

* 5. Number of Participants

* 6. Age Range of Participants

* 7. Number of Chaperones

* 8. Number of Chaperones That Will Participate 

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

* 10. Desired Location 

* 11. Desired Event Format

* 12. Mailing Address

* 13. City, State and Zip Code 

* 14. Preferred Dates (Please include multiple options)

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

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

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

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

* 19. Please list any additional questions or concerns.

* 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?

* 21. How did you hear about our program?

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