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STEP 1

Enrollment Form

Step 1 of 11

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Thank you for your interest in our Summer Programs!!
First things first, how did you hear about us? * Required
Program Selection
Top Rope Rock Climbing
- Program 1 | July 10th-July 13th, 2023
Teen Backpacking
- Program 1 | July 19 – 26, 2023
Adventure Academy
- Week 1: May 23-May 26, 2023; Week 2:May 30th-June 2nd, 2023
Must be a student at Burchell High School
Have you applied for a scholarship with one of our partners? If YES, please select whom:
- Youth 360
- Knik Tribal Council
Disclaimers
Please Read the following information and please let us know if you have any questions.
Consent for photographs: * Required
I agree to the photo policy.
Onward & Upward’s staff may potentially use photos with your student in them as a part of our marketing materials, advertising, website, grant applications, and to illustrate our programs. Check the box above if you Agree to this policy.
Equipment Students will be provided with a gear list and must come prepared with the necessary gear. Many items may be available for use upon request such a rain gear, fleece layers, sleeping bags, sleeping pads, etc. etc. All group gear is provided such as tents, cook stove, cook shelter, cook pans, water disinfection system and food.
The following forms are required for participation in this course and include:
1. Onward & Upward Essential Eligibility Criteria
2. Onward & Upward Participant Agreement Form
3. Onward & Upward Medical & Health Information
4. Rules of Conduct
5. Demographics

Essential Eligibility Criteria
Purpose and Intent

Onward & Upward is intentional in using adventure and experiential learning activities to promote individual and community wellbeing. However, Onward & Upward is not a therapy program and does not use program activities in a prescriptive manner. We value diversity and a positive learning environment, but do not specialize in experiences for people with disabilities or with significant mental, emotional, or behavioral challenges. Our instructors are not therapists and not trained in adaptive wilderness or integrative teaching skills.

Adverse Environmental Conditions

Our summer expedition programs range from 4 days to 8 days. The wilderness environment in which our expedition-based programs take place are challenging and remote. At times students may feel challenged physically and emotionally. Students may feel wet, tired, hungry, sore, homesick, frustrated, and emotionally stressed. There will be no access to technology and a lack of other usual coping skills. Students will be ‘living’ in close quarters and may not have the level of privacy or time to themselves as they generally would. Our expedition-based programs are not appropriate for students who:
- Have signs of or are not stable in managing mental illnesses such as:
- Are just leaving residential treatment facilities. Students need to be in a period of stability for at least six months.
- Are self-harming, having suicidal thoughts or engaging in risky behaviors.
- Experiencing acute psychosis.
- Demonstrating problematic sexual behaviors.
Please let us know if your student is experiencing any of the above and we will help direct you to other resources to best support your student and family. If your student is currently being treated for and is stable in a mental, emotional, or behavioral health disorder, you may provide a note from their Licensed Health Care Provider to guide us in providing your student with the best support possible. The physical and emotional health and safety of our students and staff are a top priority. The following Essential Eligibility Criteria (EEC) is to ensure the program is appropriate for students and will not increase the potential of any harm. The EEC is applied to all students on expedition-based programs. If an applicant does not meet specific criteria, Onward & Upward might be able to accommodate an applicant but will not do so if it significantly alters the fundamental nature of the course activity, jeopardizes the health and safety of students or staff, or places an undue administrative or financial burden on Onward & Upward.

General Eligibility Criteria
- Students are participating in a course because they want to and are there on their own accord.
- Able to understand verbal and visual instructions individually and in a group setting and follow such instructions whether supervised or not.
- Able to recall and understand hazards and risks previously explained by instructors.
- Able to effectively alert and warn others of potential or impending dangers such as falling rocks, aggressive animals, or other environmental hazards.
- Able to be responsible for their own wellbeing and self-care by staying hydrated and nourished, taking care of their personal hygiene, and effectively communicate with others personal distress injury or need for assistance.
- Be able to refrain from the use of alcohol, tobacco, controlled substances, and any misuse of prescription or over the counter drugs.
- Able to contribute to a safe social and learning environment and maintain appropriate relationships with other group members and instructors, refrain from sexual activity, harassment and bullying and all other behavior that disrupts the learning of others or the cohesion of the group.
Activity Specific Eligibility Criteria

Along with following Activity Specific Eligibility Criteria courses will also have age requirements as curricula/programs are designed for specific age groups.

Backpacking Courses
- Able to carry a backpack weighing 30-40 pounds or approximately one-third of their body weight.
- Able to travel each day, traveling 3-5 miles a day wearing a loaded backpack, off-trail, over uneven terrain, with elevation gain and loss and through water drainages.
Rock Climbing Courses
- Able to be physically active throughout most of the day.
- Able to hike carrying 20-30 lbs., on or off trail for 1-2 miles a day.
- Able to wear a climbing harness and helmet correctly.
- Able to participate in belaying and climbing activities.
Canoe Courses
- Able to wear a Personal Flotation Device (PFD or “life jacket”) correctly, able to maintain a face-up position in water while wearing a PFD and make progress through the water to shore or a rescue boat.
- Able to sit and kneel in a canoe and maintain stability.
- Able to help carry a 75-pound canoe with another person on or off trail.
- Able to travel over uneven terrain on or off trail.
Non-Discrimination Policy

Onward & Upward does not discriminate against any person of the basis of race, color, sex or sexual orientation, gender identity, religion, age, national or ethnic origin, political beliefs, veteran status, or disability in admissions to, access to, treatment in or employment its programs and activities.
* Required
- I have read and understand the student eligibility criteria.
- My student is choosing to participate in this program on their own accord.
- I understand that Onward & Upward’s programs are not treatment programs. I testify that my student has been in a period of mental, emotional, behavioral stability for six months or more.

Participant Agreement, Release and Assumption of Risk
In consideration of the services of Onward and Upward Inc., their agents, owners, officers, volunteers and all other persons or entities acting in any capacity on their behalf (hereinafter collectively referred to as “O&U”), I hereby agree to release, indemnify, and discharge O&U, on behalf of myself, my spouse, my children, my parents, my heirs, assigns, personal representative and estate as follows:
1. I acknowledge that my participation in guided hiking, camping, backpacking, crossing creeks, rock climbing, rappelling, fishing from shoreline, ice fishing, community service projects, team building and leadership games, problem solving exercises, athletic activities, orienteering, snowshoeing, cross country skiing, high and low ropes course, transportation via vans and training and instruction including remote learning activities entails known and unanticipated risks that could result in physical or emotional injury, paralysis, death, or damage to myself, to property, or to third parties. I understand that such risks simply cannot be eliminated without jeopardizing the essential qualities of the activity. The risks include, among other things: slips and falls; falling from significant heights, falling objects; rugged terrain, boulders and creeks; weather conditions; water hazards; accidental drowning; being impaled by a fishing hook; collision with fixed or movable objects; cuts, bruises, burns, abrasions, concussions, strains, sprains, muscle soreness and fractures; musculoskeletal injuries including head, neck, and back; injuries to internal organs; loss of fingers or other appendages; exhaustion; exposure to temperature and weather extremes which could cause frostbite, hypothermia, hyperthermia (heat related illnesses), heat exhaustion, sunburn, dehydration; exposure to potentially dangerous wild animals, insect bites, and hazardous plant life; equipment failure and/or operator error; improper lifting or carrying; being lost or separated from their instructors or companions; the negligence of participants, or other persons who may be present; accidents or illness can occur in remote places without medical facilities and emergency treatment or other services rendered; transmissible pathogen or disease; traveling to and from activity locations raises the possibility of any manner of transportation accidents; my own physical condition, and the physical exertion associated with this activity. Furthermore, O&U personnel have difficult jobs to perform. They seek safety, but they are not infallible. They might be unaware of a participant’s fitness or abilities. They might misjudge the weather or other environmental conditions. They may give incomplete warnings or instructions, and the equipment being used might malfunction.
2. I expressly agree and promise to accept and assume all of the risks existing in this activity. My participation in this activity is purely voluntary, and I elect to participate in spite of the risks. I agree to wear a properly fitted and secured helmet while participating in climbing activities and high ropes courses.
3. I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless O&U from any and all claims, demands, or causes of action, which are in any way connected with my participation in this activity or my use of O&U’s equipment or facilities, including any such claims which allege negligent acts or omissions of O&U.
4. Should O&U or anyone acting on their behalf, be required to incur attorney’s fees and costs to enforce this agreement, I agree to indemnify and hold them harmless for all such fees and costs.
5. I certify that I have adequate insurance to cover any injury or damage I may cause or suffer while participating, or else I agree to bear the costs of such injury or damage myself. I further certify that I am willing to assume the risk of any medical or physical condition I may have.
6. In the event that I file a lawsuit against O&U, I agree to do so solely in the state of Alaska and I further agree that the substantive law of that state shall apply in that action without regard to the conflict of law rules of that state. I agree that if any portion of this agreement is found to be void or unenforceable, the remaining document shall remain in full force and effect.
By signing this document, I acknowledge that if anyone is hurt or property is damaged during my participation in this activity, I may be found by a court of law to have waived my right to maintain a lawsuit against O&U on the basis of any claim from which I have released them herein. I also agree that this document is valid for subsequent visits and participation at O&U. I have had sufficient opportunity to read this entire document. I have read and understood it, and I agree to be bound by its terms.
Participant Digital Signature * Required

By signing your name electronically, you are agreeing that all information provided on this form is accurate and true to the best of your knowledge. You are stating that your electronic signature is the legal equivalent of your manual signature on this form. You will receive a copy of this form.
Parent or Guardian Digital Signature * Required

By signing your name electronically, you are agreeing that your electronic signature is the legal equivalent of your manual signature on this form. You will receive a copy of this form.

General Information
Name * Required
First Last
Phone * Required
Address * Required
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Email * Required

Medical & Health General Information
Age * Required
Date of Birth * Required
MM slash DD slash YYYY
Grade * Required
School
Gender at birth
Why do we ask for this information?
Onward & Upward is committed to pursuing gender-based diversity goals in our course offerings. We welcome students of all genders and ask for gender information in the enrollment process to open conversations that will ultimately contribute to a healthy learning environment for all participants. Examples of when knowing a student’s gender is important for purposes of safety or engagement include:

1) We use gender-based sleeping arrangements on many courses, and our goal is to make people of all genders as comfortable as possible.

2) Privacy, a concern for all genders, may pose a greater concern for transgender and other gender-expansive students, so we seek to inform about situations where strict privacy is not possible.

If you have any questions or concerns, please reach out to info@onwardandupward.org. You’ll hear back from someone who can answer your questions and will happily discuss any of your concerns.
- Female
- Male
- Prefer to self identify
Prefer to Self Identify Additional Information (optional)

Examples include but are not limited to agender, gender fluid, non-binary, trans female. Please also feel free to share your pronouns.
Onward & Upward is committed to pursuing gender-based diversity goals in our course offerings. We welcome students of all genders and ask for gender information in the enrollment process to open conversations that will ultimately contribute to a healthy learning environment for all participants. Examples of when knowing a student’s gender is important for purposes of safety or engagement include:

1) We use gender-based sleeping arrangements on many courses, and our goal is to make people of all genders as comfortable as possible.

2) Privacy, a concern for all genders, may pose a greater concern for transgender and other gender-expansive students, so we seek to inform about situations where strict privacy is not possible.

If you have any questions or concerns, please reach out to info@onwardandupward.org. You’ll hear back from someone who can answer your questions and will happily discuss any of your concerns.
Name of Parent/Guardian * Required
First Last
Parent/Guardian Phone * Required
Parent/Guardian Email * Required
Alternate Emergency Contact * Required
First Last
Emergency Contact Phone * Required
This information is required in the event a participant needs medical attention.
Health Insurance Carrier * Required
Policy # * Required

Medical Information
Allergies/Anaphylaxis (including medications, foods, animals, bites, stings and environmental). * Required
- Yes
- No
History of Respiratory Problems? Asthma? * Required
- Yes
- No
Diabetes * Required
- Yes
- No
Seizure within past year * Required
- Yes
- No
Cardiac Conditions/High Blood Pressure * Required
- Yes
- No
If you checked YES to any of the Above, provide Details below or put N/A * Required
Please include allergy, reaction(s), medication requirements and dosage
Medication (including over the counter and/or prescribed medication). * Required
- Yes
- No
If you checked YES, Please include medication, condition, dosage (amount/frequency), and side effects. Provide details below or put N/A: * Required
Onward & Upward is required to store medications in a manner that prevents access by unauthorized persons. Instructors will carry medications for students, and assist in the self-administration of medication (see form section: Assistance with Self Administration of Medication )
- If medication is listed and your student is attending an overnight program, please review and sign our Assistance with Self Administration of Medication Form
- We have a zero-tolerance policy for students bringing any substances that are not listed on the health form. Possession of alcohol, tobacco, marijuana or any other illicit substances will result in dismissal from the program.
Current medical (physical, emotional, mental) conditions. * Required
- Yes
- No
If you checked YES, provide Details below or put N/A
List any previous diagnosed conditions and let us know how to provide the best care possible to your student. Please Include: Severity of Condition, Date of Diagnosis, and How the condition is managed.
Other pertinent information (phobias, sensitivities, behaviors, special needs, etc). * Required
- Yes
- No
If you checked YES, provide Details below or put N/A
If your child is currently seeing or has not yet seen a Licensed Health Care Provider (LHCP) for any of the above medical information provided above, Onward & Upward suggests receiving a recommendation from a LHCP prior to participating in this program. If your LHCP would like more information about the program, they may call:
Randy Dowd, Executive Director at (907) 953-5360 or
Amanda Montavon, Director of Operations at (907) 982-4144
Name of Licensed Health Care Provider
Profession
Recommendation
Please include any other information that is pertinent to your child's participation in this program
* Required
- I understand that Onward & Upward does not practice medicine, and that I should consult with a licensed health care provider if I have any concerns about my child participating in the Adventure Based Education programs offered by Onward & Upward. Knowing that Onward & Upward’s staff are trained in Wilderness First Aid and CPR, I hereby authorize the Onward & Upward staff to provide first aid care according to their training if needed by my child while on an Onward & Upward program.

Assistance with Self Administration of Medication
DESCRIPTION

Onward & Upward may provide Assistance with Self Administration of Medications (ASAM) when:
- Students are under the age of 18
- Medication is time-sensitive and needs to be taken during an Onward & Upward program.
- A student’s parent or legal guardian is not present to assist the student.
MANAGING MEDICATIONS

Onward & Upward is required to store medications in a manner that prevents access by unauthorized persons. We will store/carry student medication in individual water proof bags that are labeled with the student’s name. Students are able to carry their own asthma inhalers and epinephrine auto-injectors, but should communicate to staff where these medications are kept within their bag. Staff will also manage/carry some over-the-counter PRN (as needed) medications, such as: Ibuprofen (anti-inflammatory), antihistamines (allergy medication), Diamode (diarrhea medication) and Doscusate (stool softener). Staff may provide students with these medications as needed, following the directions for dose, duration and/or method of administration specified on the manufacturer’s label.

PROCEDURES

Staff will follow the following procedures for assisting in the self-administration of medication.
1. Remind the student/recipient to take their medication.
2. Assist one person at a time.
3. Make sure all needed supplies (such as food or water) are available.
4. Wash their hands before, after and between assisting with medications.
5. Check & confirm the following against the label of the medication container:
  - Right drug, right dose, right time, right route & right person
6. Observe the recipient while they take their medication.
7. Document medication taken.
PARENT RESPONSIBILITIES

Parents/legal guardians are responsible for:
- Parents should ensure that the appropriate dosage amount is provided for the duration of the program. It is recommended that only the required amount with a day or two of additional dosages is provided. The additional dosage may be used in the case that a medication is dropped or the program is delayed.
- Medications must be in original containers, properly labeled with the name of the recipient for whom it is intended, the name of the medication, the dosage, expiration date and directions for administration.
- The parent must consult with their child’s health care provider about any potential contraindications in regards to medical conditions, medications and their participation in Onward & Upward program activities.
I hereby request and authorize Onward & Upward staff to administer first aid care and to assist in self-administration of both prescribed and PNR (as needed, over the counter) medications in accordance to their training. I have read the medication procedures outlined on this form and assume the responsibilities as required.
* Required
- I have read, understand, and agree to procedures for assisting in the self administration of medication.

Fitness Assessment
Most our programs are structured to accommodate various levels of participation based on your child’s medical abilities. Regardless of your child’s physical condition, we expect your child to pay attention to their body in choosing their level of participation.
Current Exercise Activity Level * Required
- None
- Easy
- Moderate
- Competitive
Exercise/Activity Details * Required
Please include activity, frequency, approximate time and distance.

Rules of Conduct
These rules are in place to protect the wellbeing of students and staff. Failure to abide by these rules may result in removal from the program and possible criminal prosecution. All participants are held to the following rules of conduct:
- Students must avoid behavior that endangers themselves or others, including staff.
- We do not permit use or possession of alcohol, tobacco or any illicit substances.
- Over-the-counter medications and prescriptions may only be self-administered with specific permission from parents or physicians. All medication is held by appropriate staff and self-administered by participants under staff supervision.
- Weapons or articles which staff believe could be used as a weapon, including personal knives, are not allowed.
- Students may not leave the program without permission of staff or their parent/guardian. If a participant makes a request to leave the program, staff will notify their parent/guardian to discuss the options for exiting the program. Sometimes while on backcountry portions of the program immediate departure from a program is not available.
- Students may not engage in violence or threaten violence. Violent behavior includes both physical aggression, verbal aggression or sexual misconduct.
- Onward and Upward follows an established risk management plan. Students may not engage in risky behaviors or fail to follow instructions regarding safety issues.
Failure to abide by these rules may result in dismissal from the program and possible criminal prosecution. If these rules are broken during a backcountry portion of the program evacuation fees may be accrued and will be charged to the student’s parent/guardian.
* Required
- Student: I have read, understand, and agree to follow the rules of conduct.
- Parent/guardian: I have read and understand the rules of conduct. I agree to accept responsibility for any financial evacuation fees that may accrue as a result of my student being dismissed from the program.

Digital Signature
Participant Digital Signature * Required

By signing your name electronically, you are agreeing that all information provided on this enrollment form is accurate and true to the best of your knowledge. You are stating that your electronic signature is the legal equivalent of your manual signature on this form. You will receive a copy of this form.
Parent's or Guardian's Additional Indemnification
Must be completed for participants under the age of 18
In consideration of the afore mentioned minor is permitted by O&U to participate in its activities and to use its equipment and facilities, I further agree to indemnify and hold harmless O&U from any and all claims which are brought by, or on behalf of minor(s), and which are in any way connected with such use or participation by minor.
Parent or Guardian Digital Signature * Required

By signing your name electronically, you are agreeing that your electronic signature is the legal equivalent of your manual signature on this form. You will receive a copy of this form.

Demographic Survey
Collecting the below information helps us in connecting with the people we serve, directing the focused growth of our organization and acquiring grants to provide programs. This survey is optional, and does not influence your participation in our programs. We appreciate you taking the time to provide this additional information.
Participant's age
Participant's date of birth
MM slash DD slash YYYY
Participant's gender or gender identity
- Female
- Male
- Prefer to self identify
Prefer to describe
Participant's ethnicity
- Alaska Native
- Asian/Pacific Islander
- White/Caucasian
- Hispanic/Latino
- African American
- Native American
- Other
Household
- Biological Parent(s)
- Single Parent Home
- Foster Parents
- Group Home
- Grandparent(s)/Relative(s)
- Other
What best describes your care-takers?
What is your household's annual income?
- <$20,000
- $20-40,000
- $40-60,000
- $60-80,000
- $80-100,000
- >$100,000

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CONTACT

777 N. Crusey St., Suite B105
Wasilla, AK 99654
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Phone: 1-907-745-ONUP (6687)
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Onward & Upward offers a variety of programs; allowing you to choose your own adventure!

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MISSION

To establish a culture of One Health in Alaska through evidence-based action! We offer programs that actively engage participants to step outside their comfort zones in order to discover their strengths.

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