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Pre-Trip Questionnaire
The
information you provide will be used to design a trip
that best matches your ability level, goals and
interests as well as to help select equipment, including
kayak, paddle, and wetsuit that will be a good fit for
you.
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Name:
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Phone: |
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Age:
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Email:
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Height:
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Emergency contact
(name & phone:
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Build: (large /
medium / small) |
Weight: |
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Current
level of fitness: In the last two months, how often
have you exercised for at least 20 minutes?
_____ never
_____ occasionally
_____ 1 - 2 times per week
_____ 3 - 4 times per week
_____ 5 or more times per week
Briefly describe the extent of your kayaking and
canoeing experience (if any):
Please identify any temporary or long-term medical
conditions which could potentially become a factor
during a kayaking trip:
Please identify any allergies, including allergies to
insects:
Trip Goals:
Please each of the following in terms of importance,
from 1 - 10, with 10 being of maximum importance. (More
than one item may be ranked 10, for example):
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______ physical exercise
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______ adventure |
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______ natural history / marine life
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______ relaxation |
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______ exploration / discovery
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______ improve kayaking skills |
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______ spend time with friends |
______ physical challenge |
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______ adrenaline rushes |
______ enjoy natural beauty |
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______ other: (please
describe):
___________________________________________________________________
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