March Break Wild Explorations 4 Youth  Application Form
We are taking applications for our March Break outdoor program for Youth (12 – 15 yrs). Please complete all the relevant fields below and we will be in touch by Wednesday Feb 10th regarding a spot for your child.  
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Our March Break session is a winter outdoor program which runs for four days - Monday March 15th until Thursday March 18th from 9:00 am - 3:30 pm each day.  Please consider if your child has any conditions that would prevent them from being  physically active in the outdoors for several hours at a stretch each day. We will build our stamina gently and will have some indoor time each day, but this is predominantly an outdoor program.  We want to make sure this program is a good fit for all participants. We are limited in the accommodations we are able to make.  Please confirm the following: *
In what ways do you think this program would be good for your child / the participant? *
First and Last Name of Participant *
Date of birth of participant (Month and Year) *
Where does your child live?  (Name of town or village only) *
Name of parent / guardian *
Contact email address  (indicate your preference for being contacted by phone or email) *
Parent/Guardian phone number *
Flying Squirrel Adventures is strongly committed to fostering diversity and inclusion within our programs and encourages applications from all qualified candidates. Candidates who belong to equity-deserving groups are particularly encouraged to apply; including Black, Indigenous and People of Colour, members of the 2SLGBTQ+ community, people with disabilities and other equity-deserving individuals. Candidates who identify as being from any of these groups are encouraged to voluntarily self-identify in this section. This information will be kept strictly confidential.
What aspects of the program are you most interested in for your child / is your child more interested in? *
Required
Does your child have any dietary restrictions (yes/no)? If yes, please describe. *
Does your child require transportation support? *
If you require transportation support, please let us know the pick and drop off locations (street and town name) .  This info will be used for transportation planning purposes.
How did you find out about this program *
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