Outdoor Trips Questionnaire

Name Name First Last
Email
Which week are you hoping to take an Outdoor Trip?

Which week are you hoping to take an Outdoor Trip? Week 1: Tuesday, July 29–Friday, August 1 Week 2: Tuedsay, August 5–Friday, August 8

Please note: Week 1 is for International Orientation and Pre-Enrollment Program participants only.
General Physical Condition

Please list any sports, daily exercise, or other activities that improve, maintain or otherwise affect your physical condition.
Have you ever hiked or climbed with a pack of at least 30-40 pounds? *

Have you ever hiked or climbed with a pack of at least 30-40 pounds? * Yes No
Please describe your hiking experience *

Distinguish between mountainous terrain and flat land and name the areas involved. Were you on a day trip or did you carry food and shelter with you? Please be specific, we need to know your level of experience.
All trips are scheduled to do some water-based activities; everyone will wear a life jacket at all times. How would you rate your swimming ability? *

All trips are scheduled to do some water-based activities; everyone will wear a life jacket at all times. How would you rate your swimming ability? * Cannot swim Average swimmer Strong swimmer
Medical Information *

Please describe in detail any medical conditions, past injuries or allergies we should be aware of.
Dietary Requirements *

Please describe in detail any unique dietary requirements we should be aware of.
Please be aware of the following two important details:

- All trip participants must have health insurance at the time of the trip.
- All trip participants will be asked to sign a standard waiver form.

Thank you! Please let us know if you have any questions by emailing mba.program.office@dartmouth.edu. We look forward to meeting you!