Healing of the Trails
Cohort Application

Name *

First Name

Last Name

Birthday

MM

DD

YYYY

Phone

(###)

###

####

Mailing Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Healing of the Trails includes activities such as hiking, storytelling, and traditional practices. Are you comfortable participating in these activities?

Yes

No

Not Sure

Are you willing to commit to the entire program schedule?

Yes

No

Do you have reliable transportation to attend in-person sessions and activities?

Yes

No

Sometimes

Acknowledgment

By submitting this application, I affirm that the information provided is accurate and that I am committed to participating fully in the Healing of the Trails program. I understand that this program involves outdoor activities, cultural learning, and community engagement.

I agree

I disagree