La Vida College Expedition Enrollment Form

La Vida College Expedition Enrollment Form

Please give thought to each answer so that we can get to know you better before your trip. The La Vida staff use this form to place you in a group. We will follow up with you on any food or medical needs you might have.
First Name
Last Name
Preferred name, if applicable
College ID number (Please ensure correct entry so we can match your record.)
Gordon Email
example@example.com
Personal Email
example@example.com
Household/parent or guardian email
example@example.com
Sex
Age
Birth date (mm/dd/yyyy)
Year in college at time of registration
Is your phone a USA/Canadian or International number?
Cell Phone
Please enter a valid phone number.Format: (000) 000-0000.
Home Phone
Please enter a valid phone number.Format: (000) 000-0000.
International Cell Phone
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
The dates below are for the 2027 Summer season. Course preference and availability for PED016. Please note the August trip may be split into two departure dates to accommodate the number of students. You will be notified of your departure date after you apply. International Students are strongly recommended to sign up for August expedition to ease travel logistics.
*NOTE: (1) The August 8 - 19, 2027 La Vida trip may be split into two departure dates: Saturday, August 7 or Sunday, August 8. Once you register, we will notify you of your departure date. All trips end on Thursday, August 19. (2) If all August spots become full, you will be put on a waitlist. We will then email you what spot you are on the list.
Specific trip type request (The primary mode of travel for "Mountain" is hiking on trails. The main mode of travel for "Canoe" is on the water. )
Reason for trip type request:
Please Note: While we do our best to honor specific trip type request, they are not guaranteed. We consider a variety of factors when making up expedition groups, and you will receive your final assignment 2-3 weeks before the expedition begins.
Height
Weight
Major
Extracurricular activities:
How did you hear about and decide to register for this expedition?
What is the main reason you want to go on the trip?
Most students have never camped before La Vida, but if you have any previous camping, hiking, or canoeing experience, please let us know:
What three words best describe your temperament?
What three goals would you hope to accomplish during your La Vida experience?
La Vida highly values community and the input of each individual in the group. What gifts, talents, values, etc., would you bring to your La Vida small group?
Are you taking any prescribed medications? Please list the medication and reason for taking it. Do you anticipate any change in medication or dosage for your expeditions?
Do you have any allergies or dietary needs? Please check all that apply.
Please explain the allergy and its severity:
Do you carry an EpiPen for your allergy? (If yes, please note you must bring your own EpiPen in addition to the ones we carry in the first-aid kit.)
Due to the strenuous nature of the activities and remote environment, are there any physical, emotional, or mental health concerns we need to be aware of?
Are there any special logistical need or requirements for this experience?
Our trip leaders pray for you by name before the expedition. Do you have any specific prayer request for this experience?
On a scale of 1 to 10, rate yourself in health
1- Health related issues are extremely challenging 10- No on-going health issues
On a scale of 1 to 10, rate yourself in physical strength
1- A lot of difficulty lifting and carrying 30 lbs suitcase 10- Can easily lift and carry a 50 lbs suitcase
On a scale of 1 to 10, rate yourself in endurance
1- Difficulty talking after walking up one flight of stairs 10- Able to jog 5+ miles
On a scale of 1 to 10, rate yourself in desire for spiritual growth
1- Not interested in spiritual discussion or reflection 10- Extremely interested in spiritual growth
Would you like to clarify any of the ratings above?
Are you an international student?
Please read La Vida's College Expeditions Billing and Cancellation Policy.
I have read the cancellation policy linked above and agree to abide by that policy. I understand that I may be charged $50-$300 for canceling before the trip starts
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