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YATES LEADERSHIP CHALLENGE COURSES REGISTRATION FORM

The following form forwards information to the Daniels Leadership Center Staff in order to reserve your event at the Yates Leadership Challenge Courses.

It does not guarantee the availability of the date and time/s you are requesting. The manager will contact you to confirm the date and time/s once the form is submitted.

If you have any questions about this form please feel free to contact us.

 

Your Organization's Name

Primary Contact and Title

Legal Binding Name on Contract

Address

City State Zip

Organization's Phone

Organization's Fax Number

Organization's Email

Estimated Date (if unknown give range of dates or write in "TBA")

Estimated Time of Arrival Estimated Time of Departure

Which Events are you Requesting?
High Ropes Low Ropes Cooperative Games Leadership Reaction Course

Event Length? Full Day Half Day Other

Approximate Number of Participants

What is the Age Range of Participants (estimate if needed)

Accommodations (additional charges may apply)

 

Drinks (non-alcoholic) Yes No
Lunch/Dinner Yes No
Other (please specify)

 

Goals (Select up to 3 goals)

 

Alleviate stress and increase fun Improve developing a vision
Create a positive work environment Improve empowering subordinate skills
Develop group cohesion Improve ethical decision making
Encourage higher productivity Improve goal setting
Encourage critical thinking skills Improve problem solving skills
Form/strengthen relationships between members Improve trust in group members
Foster collaboration and support Improve verbal and non-verbal skills
Gain insight on leadership Increase individual confidence
Improve attention to detail Increase the value of respect for others
Improve communication skills Learn followership
Improve conflict management skills Tap into creativity and innovation
Improve coping with stress Teach supervisory skills
Improve delegating skills  
Other:

 

Do all of the Participants know each other? Yes No Mostly  Somewhat

Do any Participants Have any Physical Challenges? (wheel-chair, crutches, etc.) No
If Yes, please explain

Would you like a Tour of NMMI? Yes No

Method of Payment Check

Other

Forms to Download and Submit Before Participating

1. Please download and print the Liability and Medical Release Form Here

2. Read the Expectations / FAQ Page or download the pdf letter here .

3. Completed the form for each participant and return the form by US mail or by fax to:

Mail:

Yates Leadership Challenge Courses
New Mexico Military Institute
101 W College Blvd
Roswell, NM 88201

Fax: (575) 624-8318

Phone: (575) 624-8139

Campus Map / Travel Directions from Different Points / Travel Directions using Google Maps

Any Other Comments: