Intake form

Name *

Email address *

Home Address *

Phone number

Level of hiking experience *

Please select at least one option.

Beginner (little to no hiking experience)

Intermediate (have hiked in the past, comfortable on trail)

Advanced (regular hiker, have hiked several times)

What are you hoping to gain from your experience?

Please select at least one option.

Physical health improvement

Mental health improvement

Wanting to unplug for a while

Seeking inspiration in nature

Take photos

Current health condition *

Please select at least one option.

Bad

Fair

Good

Excellent

Emergency Contact *