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  Program Inquiry  

Please complete this form as completely as possible, When you are finished, click "Submit". Please allow 24 hours from the time we received your inquiry to contact you to further discuss your request.

Please us "NA" for any questions that do not apply to you and "?" if you do not currently have that information.

Company/Organization/Group name:

Your Name:

Title:
E-mail Address:

Fax:

Phone number(s):

Where did you hear about Interactive Adventures?

What type of program are you seeking? (Click one)
Team Building
Indoor Rock Climbing
Other

If "Other", please explain:

If "Team Building", how long would you like this session?
(skip this question if you do not know)
Less than 3 hours
3 hours (half-day)
7 hours, with break (full day)

Please indicate any particular days/times you are interested in having this program:

How many people would attend this program?

Please summarize your/your group's objectives for this program:

Please describe the nature of this group's relationship and in what capacity they interact:

Please indicate how well acquainted your group members are/will be with each other:

Is there anyone in the group that has a disability or condition that would limit physical activity?

Is anyone in the group deaf or hearing impaired?
Yes
No
How many?

Please note that it is your responsibility to make arrangements for interpreters.

Thank you for taking the time to provide us with this information. If you are finished and would like to submit this inquiry to our office, click "Submit".

THANK YOU!