Participant Intake — Wildflower Outdoor Recreation

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Participant Intake Form

Tell me a little about the participant, what kind of support helps them feel successful, and what adventure you are interested in. Completing this form does not confirm a booking — Olivia will follow up to confirm fit, availability, session details, safety, and payment. You can also request a free 15-minute intake call after submitting the form.

New to Wildflower? Complete the intake form below. Already completed an intake? Use the Google booking calendar to book another session. Please include any preferred lesson dates and times below.

Good to know: Wildflower sessions are recreational and community-based. They are not therapy, medical care, behavioral crisis care, or childcare. Sessions are confirmed only after Olivia reviews the intake and follows up.

Participant name *

Participant age *

Parent, caregiver, or participant name *

Email *

Phone

Preferred contact method

How many participants?

Activity you are interested in

Preferred day

Preferred start time

Preferred end time

Preferred session length

Participant interests

Support needs, communication style, sensory needs, or disability-related information *

Goals for the session

Safety, medical, allergy, dietary, or behavioral notes

Funding or payment notes

Anything else you want Olivia to know?

I understand that submitting this form does not confirm a booking, and that Olivia will follow up to confirm fit, availability, session details, safety, payment, and any required forms.

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