Wilderness Survival Package

Use this form if you want to book the Colorado Mountain Club Youth Programs Wilderness Survival Package. The Wilderness Survival Package is located at the Colorado Mountain Club Basecamp, 15605 W. 32nd Ave, Golden, CO and can serve up to 80 students.

This is for a program package only. If you want any customization to this form, please use the Custom Program Registration Form.

= required field

Today's Date

Your E-Mail Address

School/Group

Group Coordinator Name

Group Coordinator Phone Number

Billing Contact Name

Billing Contact Email Address

School District

County of School/Group

Desired Program Date (1st Choice)

Desired Program Date (2nd Choice)

Desired Program Date (3rd Choice)

Expected Number of Students

Student Grade Level

Desired Rotation Schedule

Program Choices (choose as many choices as you have rotations. 3 rotations= 3 choices) If you would like more than one rotation of the same activity (ie 2 rotations of teambuilding), please note that in the additional comments below.

How many teachers/chaperones plan to attend? 1 teacher/chaperone per rotation is required.

Are there any unique student needs or tips for working with your students?

Is your school a Title 1 School?

Do you need financial assistance? If yes, please fill submit application here: https://forms.gle/Vs74Z6eBPFdjmrf68

How did you hear about CMC Youth Programs

Additional Comments

Wilderness Survival Package

CMC

The CMC

Connect with the CMC Community

Connect with the CMC Community