WILD TEENS 2021-22 Application
Parents, please complete this form to apply for WILD TEENS.

We will get back to you quickly to confirm that your teen has a space, and to let you know how to proceed with registration and payment.

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Email *
Teen's Name *
Birthdate *
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DD
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YYYY
Parent Name(s) *
Parent Email *
Phone *
Why does your teen want to join Wild Teens? What are they hoping to get from the experience?
This program takes place outdoors in all weather, and includes fun and exciting activities that can also sometimes be physically and emotionally challenging.  Does your teen have any physical, mental, or emotional conditions that may limit or impact participation in this program? If so, please describe: *
Does your teen have any social or behavioural challenges? We will be a small group working together, sometimes relying on each other in remote wilderness situations, and often sharing vulnerably in talking circles. We try to assure that this is a good fit not only for your teen, but for the group.
Additional comments or notes to WILD TEENS staff:
A copy of your responses will be emailed to the address you provided.
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