Courage Miller Partners Challenge Course Program Form

ODU Courage Miller Partners Challenge Course

Program Registration Form
Please make the reservation, as well as full payment for the program, at least two weeks (business days) before the event date.
Today's Date:
Name:*

First NameLast Name
Title/Position:
Organization*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail*
Phone Number*
Please select your group/organization type:*

ODU Student/Student GroupODU Affiliated GroupNon ODU Organization (Non-profit)Non ODU Organization (For Profit)
Please share the primary reason your group is interested in this program:
Please select the elements that are important to your group:

Play/FunGroup DevelopmentEffective FeedbackExploring DiversityConfidenceCooperationDecision MakingMotivationTeam BuildingProblem Solving SkillsVisualizationCommunicationConflict ResolutionGroup ConsensusTrust BuildingCreativityPeer Respect
Please select your prefered program date below:
Date*

MonthDayYear
Number of participants:
Please provide any additional comments or thoughts regarding your desired program design and outcomes:
Should be Empty:

ODU Courage Miller Partners Challenge Course