Pre-Course Participant Information

"*" indicates required fields

1Name and Course

2Participant Information

3Experience Assessment

4Camper Information

What course are you enrolled in or will be enrolled in?*

If you are enrolled in more than one course please select the course that will occur FIRST.

Course Start Date

Name*

First Last

Phone*

Email*

Camper's Name*

Camper First Name Camper Last Name

Additional Camper?*

Yes

Second Camper's Name

Second Camper First Name Second Camper Last Name

Jr Instructor's Name*

Jr Instructor's First Name Jr Instructor's Last Name

How did you hear about us?

Hidden

Additional Courses

If you are enrolled in or will be enrolled in additional courses please list below:

Pre-Clinic Student Experience Assessment

This is an elective section for additional information to help develop your instructional experience with H2o Dreams and guide your placement in our programs. If you have had previous experiences on whitewater, we recommend taking time to answer the questions below thoughtfully.

Have you taken a swiftwater rescue class in the past year?

Some of our courses require additional rescue and training skills as you are expected to be an active part of the group safety.

Yes

Do you have First Aid / CPR training?

Some of our courses require additional rescue and training skills as you are expected to be an active part of the group safety.

Yes

Have you ever had any formal instruction?

Yes

Where did you receive instruction, and how much instruction have you had?

How did your paddling skills get to where they are today?

How often do you paddle? About how long do you paddle during each outing?

What rivers do you regularly paddle?

Do you run all the main lines/rapids? Do you explore new lines?

Describe your most challenging day of paddling. What was the quality of that experience?

Describe your paddling group. What is your role within that group?

What equipment do you carry with you while paddling?

Please be thorough! Use this space to detail what gear you will bring with you for class as well as any equipment needs you may have from H2o Dreams.

At what skills do you excel? What skills need work?

When was the last time you had a combat roll (an unplanned roll on the river)? When was the last time you had a swim? Describe what led to those experience(s).

Please Rate Yourself in the Following Areas

Be thoughtful and honest with your self-assessments

Self Rescue

Self-rescue is defined as a safe, controlled wet-exit and recovery of equipment to shore.

How Comfortable are you with Dynamic Inversion?

Your kayak is flipped dynamically and unexpectedly and the environment is cold, dark, shallow, or turbulent.

Rolling Ability

Rolling Variability

How do you deal with fear and intimidation?

Have you ever had a traumatic experience, gone blank, not remembered, or had any setbacks - paddling or otherwise - that may be complicating success and enjoyment on the river?

Rate yourself 1-5 on the skills below - 1 being the least developed and 5 being the pinnacle.

Overall River and Group Awareness

Scouting from Shore

Scouting from Boat

Receiving Beta (info about rapids/lines)

Giving Beta

Identifying Hazards

Ability to See Lines and Execute

Read and Run Whitewater

Controlling Pitch, Spin, and Roll of the Kayak

Compound Strokes

Catching Powerful Eddies

Catching Small Eddies

Intentional Surfing

Unintentional Surfing

Knowledge and use of Basic Strokes and Biomechanics

Use of Features for Deliberate Movement on the River

Boofing Technique (Various Styles and Applications)

69625

Participant Information

Emergency Contact Information

Vital Information

Pre-Clinic Student Experience Assessment

Please Rate Yourself in the Following Areas

Rate yourself 1-5 on the skills below - 1 being the least developed and 5 being the pinnacle.

Emergency Contact Information

Camper Information

H2o Dreams Administration of Medication Authorization

Section Break

Second Camper Information

H2o Dreams Administration of Medication Authorization

Section Break

H2o Dreams Camper Release Authorization Form

For GUESTS

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