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School and Group Registration Form
Colorado Mountain Club's Youth Education Program
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* Indicates required question
Email
*
Your answer
School/Group
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Your answer
Group Coordinator Name
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Your answer
Group Coordinator Phone
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Your answer
School/Group Address
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Your answer
Billing Contact Name (If same as Group Coordinator, or same as previous year, skip to School District)
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Your answer
Billing Contact Phone
Your answer
Billing Contact Address
Your answer
School District
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Your answer
County
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Choose
Adams
Arapahoe
Boulder
Broomfield
Douglas
Denver
El Paso
Jefferson
Other
Desired Program Date (1st Choice)
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MM
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DD
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YYYY
Desired Program Date (2nd Choice)
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MM
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DD
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YYYY
Desired Program Date (3rd Choice)
MM
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DD
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YYYY
Desired Program Start Time
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Time
:
AM
PM
Desired Program End Time
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Time
:
AM
PM
Desired Program (check all that apply)
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Field Geology Hike
Nature and Ecology Hike
Leadership and Teambuilding Hike
Ecology and Wildlife (specify in additional comments if you prefer mammals, birds, or trees)
Indoor Rock Climbing
Outdoor Rock Climbing
Geology of Climbing
Physics of Climbing
Mountain Safety and Leave No Trace
Mountain Weather: Clouds
Mountain Weather: Mountain Barriers
Mountaineering Museum
Orienteering
Topography
Slacklining
Teambuilding
Indoor Snow Science
Snowshoeing: Winter Ecology
Snowshoeing: Avalanche Safety and Snow Science
Watersheds: Nature's Water Filter (Classroom)
Watersheds: Stream Ecology Field Study
Wilderness First Aid (8 hour course recommended for teens)
I'm interested in a classroom visit to pre-teach curriculum before a field trip
I would like to speak with the Youth Education Program Manager to determine the best program activities for my students.
Other:
Required
Desired Program Location
*
American Mountaineering Center (710 10th Street, Golden)
At Your School
Open Space/Field Site (if known, please specify site in additional comments)
Expected number of students:
*
Your answer
Student Grade Level
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Your answer
Any unique student needs or tips for working with your students (please specify)?
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Your answer
How many teachers plan to attend? (You are expected to bring at least one adult for every 15-20 students or group)
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Your answer
How many chaperones plan to attend? (You are expected to bring at least one adult for every 15-20 students or group)
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Your answer
What outcomes are you looking for from the curriculum/program (specific academic standards you are hoping to meet, goals for students, etc.)?
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Your answer
Have you or will you be covering any related curriculum in your class?
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Your answer
Any additional notes or comments?
Your answer
How did you hear about YEP?
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Colorado Mountain Club YEP Website
SCFD/Alliance Project
Previous Visit
Word of Mouth
Other:
Required
What is your budget for this program?
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Your answer
What percentage of your school is on free and reduced lunch?
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Your answer
Is your school a Title 1 school?
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Yes
No
Do you need financial assistance?
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Yes- please submit a scholarship application -
https://forms.gle/Vs74Z6eBPFdjmrf68
No
Submit
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