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Wilderness First Aid Certification

April 1st-2nd, 2023
Program Registration & Participant Medical Release

Contact Information


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If yes- there is an additional $15 fee due to SOLO. Please pay by check upon completion of the WFA course.

Please list any allergies known, including dietary restrictions and food allergies, vegetarian, lactose intolerant, etc. We always have vegetarian options, and will do our best to accommodate allergies, etc. Please be specific.

Please list any current or recent medical conditions.

Please list any food or environmental allergies here.

Please indicate your COVID19 vaccination status.


Permission to use Images

Experience Learning relies on the use of images of program activities and student feedback for recruitment purposes, as well as to report to and solicit financial donors. Staff members often take photographs informally throughout a program and these serve as our image library. Also, students are asked to complete evaluations at the end of a course. By signing below you agree that Experience Learning has the right to use pictures or statements by, of, or about you for aforementioned uses.


Nondiscrimination Policy

Experience Learning follows a policy of uniform nondiscrimination.

Medical and Liability Release

I understand that Experience Learning programs may involve canoeing, hiking, camping, backpacking, stream sampling and other outdoor activities. I understand the inherent risks involved in these activities and that unanticipated dangers may arise. I voluntarily assume all risk of loss, damage, illness or injury, including death, which may occur while I am participating in any activity or event associated with Experience Learning or during such times as I am under the supervision of any employee or agent of Experience Learning. I agree to hold harmless and release Experience Learning and its volunteers, employees, and agents in any location where activities are conducted. If a medical emergency does occur in route to or from or while participating in Experience Learning programs and I cannot readily be reached, Experience Learning may select any licensed physician to secure and administer medical treatment, including hospitalization and surgery for the child if and as needed. I understand any medical expense so incurred will be my financial responsibility. I have listed all the information concerning allergies, medical history or conditions, dietary restrictions and regular medication that I may take.

COVID Policy

I voluntarily seek services provided by Experience Learning and acknowledge that I am increasing my risk to exposure to the Coronavirus/COVID-19. 


Cancellation Policy

If the course is cancelled by Experience Learning we will refund all fees paid to date.  If a participant cancels more than 2 weeks out (March 17th, 2023) Experience Learning will retain $115 to offset the cost of set-up and planning.  If a participant cancels within 2 weeks, Experience Learning will retain 60% of fees paid.  This includes cancellations due to illness.


Sign here to indicate that you have read and agree to the terms in the Medical and Liability Release and Cancellation Policy.
We send out a monthly newsletter by email and an annual appeal and impact report by mail.