4-H Memorial Camp & Retreat Center Team Building Programs Request Form
Point of Contact Name
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First Name
Last Name
Name of Company/Organization/School Group
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Email
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example@example.com
Phone Number
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Please enter a valid phone number.
Billing Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Which Team Building program are you interested in? For more information about these programs, please navigate back to our website at https://4h.extension.illinois.edu/events/4-h-memorial-camp/team-challenge
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Challenge Course
Titanic Team Challenge
I would like to be contacted to learn more about these options
Has your group participated in the selected challenge before?
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Yes
No
Estimated number of participants:
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Please select your preferred dates and start times using the calendar, below. The length of the team building program varies depending on your group's needs. Programs can be can be up to 4 hours in length. If you are in need of a start time that is not listed, we are happy to work with you - please share this information in the space provided, at the end of the form.
Preferred Date & Start Time #1
Preferred Date & Start Time #2
Preferred Date & Start Time #3
Is there anything else that you would like to share with the 4-H Memorial Camp staff team?
If you have any special requests or ideas for new programs that your group can participate in, please share that information below.
How did you hear about 4-H Memorial Camp's Team Building programs?
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Previous participant
Social Media
Website
Friend/Coworker
Newsletter
Other
Thank you for completing this form! A member of our team will reach out to you as soon as possible to arrange and confirm your reservation. In the meantime, if you have any questions, please reach out to Niki by email at hoesman2@illinois.edu or by phone at 217-762-2741. *Please note that if you are completing this form during our summer season, there may be some delay in a response from our team.
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I understand that my reservation is not complete and my preferred date/time is not guaranteed until a member of the 4-H Memorial Camp team confirms with me.
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