YMCA Camp Kirkwood Retreat Questionnaire

We want to make sure your group has a great time while at camp! Please complete the questionnaire and our team will be in touch with you quickly to provide a quote and connect with you about your interest in YMCA Camp Kirkwood!
Group Name
Retreat Start Date
Retreat End Date
Reason for Event:
Estimated Number of Participants
Number of Participants (ages 18+)
Number of Participants (ages 10-17)
Number of Participants (ages 5-9)
Number of Participants (ages 0-4)
Lead Contact Name
Lead Contact Phone Number
Lead Contact Email Address
Lead Contact Mailing Address
City
State
Zip Code
Day or Overnight Event?
What type of lodging does your group prefer? (For overnight retreats only.)
If your group prefers to stay in cabins, how many do you need? Each cabin sleeps 14 people. (For overnight retreats only.)

*Additional fees will apply to groups requesting extra cabins beyond what is necessary for group size.
Meeting Space(s) Requested:
 Pavilion (Outdoors)
 Pool Pavilion (Outdoors)
 Dining Hall
 Unit Lodge
 Outdoor Chapel
 Small Side Kitchen
 None
Audio/Visual Needs:
 

Meals
Camp Provided Meals
If yes to camp-provided meals, please select which meals:
 8am Breakfast
 12pm Lunch
 6pm Dinner
How many days do you need camp-provided breakfast?
How many days do you need camp-provided lunch?
How many days do you need camp-provided dinner?
Known Dietary Restrictions:
 

Programming
Please check one of the following:
 Half Day of Activities (1-4 Hours)
 Full Day of Activities (5-8 Hours)
 No Activities
 
What activities are you interested in?
Please select all that apply:
Target Sports
 Archery
 BB's
 Slingshots
 Hatchets (ages 10+)
Outdoor Education
 Forest Ecology
 Wilderness and Leave No Trace
 Orienteering
 Pond Study
 Weather
 Animal Adaptations and Tracks
 Creeping Crawlers
Ropes Elements (weight minimum: 45 pounds, weight maximum: 300 pounds)
 V Swing
 Power Pole
 Zipline
 Tree Climbing
Aquatics
 Pool (seasonal)
 Fishing
 Boating (Canoes - Kayaks - Paddle Boards - Corkls)
Group Initiatives
 Teambuilding
 High Ropes Course (ages 10+)
 Low Ropes
 Fort Building
 Mountain Biking (ages 10+)
Activity Time Preference
Additional Notes for Activities:
Would you like a campfire? S'mores?
Would you like us to open the Camp Store at any point during your stay?
 

Comments
Additional Comments