La Vida Expedition: Essential Eligibility Criteria Response Form

Name*

First NameLast Name

Email*

example@example.com

Phone Number*

Area CodePhone Number

Select your group below:*

Gordon CollegeAdirondack Leadership ProgramOther

Are you attending a canoeing or backpacking expedition?*

CanoeingBackpackingNot yet assigned

La Vida Expeditions Essential Eligibilty Response Form:

Before filling out this form, please read through the full description and explanation of the Essential Eligibility Critera, including information on requests for modifications.

Students with a variety of fitness levels participate in the La Vida Expedition each year, and many participants have little to no hiking, camping or canoeing experience. That opportunity for growth through challenge is exactly what makes an expedition so unique and powerful!

As you answer the questions below, consider your ability to meet these requirements from a physical, mental health, cognitive, and emotional perspective.

Are you able to do the following:*

	Yes	Unsure	No	N/A
Understand and follow verbal and visual instructions individually, and in a group setting.
Comprehend hazards and safety concerns when explained by leaders, 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 personal distress, injury or need for assistance to others.
Stay properly hydrated and nourished, including drinking water regularly and eating food provided (bearing in mind food allergies are accommodated, but food preferences are not). Understand hydration and nourishment are essential for maintaining safety and health on trip.
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 (no prior camping experience is expected or necessary).
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 do the following:*

	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 7 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 do the following (if you haven't done these activities before, you will receive training on them):*

	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.

If you have an academic accommodations letter (504/IEP/similar document) that would be helpful for the La Vida to have to support you on your Expedition, please upload that below.

Is there any additional information or explanations you would like to add?