Name * First Name Last Name Pronouns * Email * Phone * (###) ### #### Age (must be age 18 or older) unless signing up for youth/adult guardian small group trip * proof of i.d. required before trip I am an adult aged 18 or older I am an adult, filling this out for myself and the youth I am an adult guardian for City of Residence * Which style of backpacking retreat are you applying for? * Choose which one best fits what you're looking for. Adult Solo : A Custom curated retreat one to one experience for $875.00 (USD) Adult Small Group : 2-3 other people on this adventure (maximum) for $525.00 (USD) per person Adult + Fur Friend : I am interested in a custom curated backpacking retreat and will be bringing my dog, to learn how to backpack safely with my furry companion for $950.00 (USD) Youth and Adult Guardian Small Group Trip (maximum 4 people, minimum 2 people) for $525.00 (USD) per person Which backpacking retreat are you applying for? * June 6-8, 2025 June 27-29, 2025 July 11-13, 2025 August 1-3, 2025 August 15-17, 2025 August 22-24, 2025 August 29-31, 2025 September 5-7, 2025 September 12-14, 2025 September 19-21, 2025 I would like to request a custom date and location Do you need an ASL Interpreter for the adventure you're applying for? (only available for select adventures at this time) * Yes No Unruly Women offers a 20% discounted retreat rate available for individuals who identify as BIPOC and/or LGBTQ+. * Please click the appropriate option. (if you want to know more, please read the about page or FAQ page) I identify as BIPOC and/or LGBTQ+ and would like the 20% discounted cost for my retreat Not Applicable Do you acknowledge that you are in charge of your own transportation to and from the trailhead? * Yes No If application is accepted, payment is required within 48 hours of application being accepted. * ok! That doesn't work for me I understand, that as of 2025 there is a $50 non-refundable deposit booking fee per person (which ultimately covers transaction fees incurred) ** this is not an additional fee to the total cost of the trip, it is included in the original cost. * choose one I understand I don't understand Why Unruly Women? What are you most looking forward to? * Have you gone backpacking before? If so, how was your experience? * Are you able to hike 5-10 miles over various terrain while carrying a 40 pound backpack? * yes no maybe Do you have any medical diagnoses that I need to know about that could potentially impact your experience and/or safety while in backcountry? * If so, please explain, so you and I can be prepared to be backpacking in the wilderness. Do you acknowledge understanding that you will be expected to pack in and pack out all of your own gear, food, etc? * yes no what do you mean, all??? Alcohol is not provided by Unruly Women LLC, and will not be provided backpacking, although there may be a circumstance that you may be in the presence of alcohol, is that ok with you? * yes no maybe I (the person filling out this application) acknowledge that I will not participate in underage drinking. * yes no I understand that we are at the will of Mother Nature, and if there are closures or if it is not safe, that our backpacking location and date are subject to change. * yes no Do you have history of injuries or physical or mental restrictions that may impact your ability to participate? If yes, please explain and we'll figure out the safest way for you to participate! * Please tell me a little about you! * What are your favorite activities/hobbies? * Can you provide your own gear? (tent, backpack, etc) * Do you need to either borrow gear from Unruly Women or need help sourcing rental gear? If so, what type of gear are you in need of? (Example: backpack, tent, etc) * Morning & Evening optional beverage preferences (choose one, none, or multiple): Morning Caffeinated Coffee Morning Caffeinated Tea Morning herbal tea (non-caffeinated) Evening Tea Evening Cider Evening Hot Chocolate How did you hear about Unruly Women? * Additional meditation and journaling prompts are offered on these retreats but are not required, are you interested? * meditation journaling not interested WOO HOO!!! Thank you for taking the time to fill this out. I will get back to you soon!
