Adult Participant Form
Name
First Name
Last Name
E-mail
This is my first time participating in a High Rocks program.
Yes
No
Please add me to the High Rocks contact list.
Yes
No
Would you like to update your contact information?
Sure!
No thanks, I've been getting all the mailings and emails from High Rocks.
Event Name
Event Location
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Next
This program was...
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Experiential
Transformational
Project-based
Personal and self-reflective
Community building
Physically active
Deep/spiritual
A safe and challenging environment
Without High Rocks I would have done this kind of thing on my own.
Yes
No
Maybe
Keep offering programs like this!
Yes
Yes, with changes
No
Doing this:
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Helped me think in a new way
Taught me new skills
Challenged me
Made me feel more confident
Connected me with new people
Describe this event in one (or two) words
On a scale of 1 to 5, 1 being terrible and 5 being great, rate this program overall.
1
2
3
4
5
Why did you choose this rating?
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If you do this program again, these are the parts you should definitely keep...
Things I'd change about this program for next time...
Write a short paragraph about what you will take away from this experience.
Please provide feedback about your program facilitators and any other comments you have about the program.
Submit
Would you like to give us any additional feedback?
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