La Vida Expedition: Essential Eligibility Criteria
Please take a few moments to complete this form. Marking "No" or "Unsure" on any of the below options will prompt a discussion with La Vida Staff about any potential need for modifications. Thank you for being honest and thoughtful as you work through this survey!
Name
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First Name
Last Name
Email
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example@example.com
Phone Number
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-
Area Code
Phone Number
Select your group below:
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Gordon College
Adirondack Leadership Program
Other
Are you attending a canoeing or backpacking expedition?
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Canoeing
Backpacking
Unassigned
Are you able to...
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Yes
Unsure
No
Understand and follow verbal and visual instructions individually, and in a group setting.
Comprehend hazards and safety concerns when explained, and adhere to safety policies and procedures even when staff and trip leaders are not immediately present.
Identify hazards posed by the environment (steep terrain, sun, cold, etc.) and other participants (fatigue, state of mind, etc.).
Effectively communicate to others personal distress, injury or need for assistance.
Stay properly hydrated and nourished, and learn skills for self-care, including proper hygiene and use of clothing and equipment.
Refrain from the use of alcohol, tobacco, controlled substances, and any misuse of prescription or over the counter drugs.
If using prescription drugs, self-administer medications under staff supervision according to New York State Department of Health regulations.
Contribute to a safe social and learning environment and maintain appropriate relationships with other group members and instructors.
Refrain from harassment, bullying, and all other behavior that disrupts the learning of others or the cohesion of the group.
Abstain from cell phone use for the duration of the program.
Wear a climbing harness, helmet and any other safety gear correctly after instructed.
Live and function in an outdoor camp setting without access to electricity for up to 12 days.
For participants bringing a personal medical device (i.e. glucose monitor, hearing aid): function in a wilderness environment, knowing it is at risk of water damage.
If attending a backpacking expedition, are you able to...
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Yes
Unsure
No
Walk continuously for up to 2 miles at a moderate pace (2 mph) over steep and uneven terrain unassisted while carrying a backpack weighing 30-50 pounds, and then repeat following 5-15 minutes of rest (up to 9 miles total in one day).
Not have immediate access to advanced medical care facilities for the duration of the backpacking portion of a program. Participants may be up to an 8 hour hike from access to definitive care.
If attending a canoeing expedition, are you able to...
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Yes
Unsure
No
In the event of a capsize, independently get out from under capsized canoe, remain face-up in water with personal flotation device, and identify, make progress to and ascend shoreline with or without instruction.
Able to assist in carrying a canoe (approx. 75lbs) over uneven terrain for up to 1.5 miles with periodic breaks.
Get in and out of a boat from the shore or from the water independently or with a reasonable amount of assistance.
Swim in water, while wearing a personal flotation device.
Is there any additional information or explanations you would like to add?
Submit
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