Conquer The Canyon®

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Team Diabetes Hiker Self-Evaluation &
Preliminary Trail Category Selection Form
(One form must be completed and submitted by each hiker)

Please complete all applicable fields of this form. The required fields are in Bold. There is a section near the bottom of the form (#33) for you to send us your questions and comments.

IMPORTANT INFORMATION

Please complete this form based upon your self-evaluation of how you feel NOW. NOT where you plan to be in the future with the exception of which trail you think you would like to hike. About half-way through your training we will survey you again to measure your improvement and/or changes. You will have the opportunity to switch trails if you choose.

Please complete this form carefully. It is the beginning of you, Team Diabetes and The Walking Connection all working together so that you have a safe, fulfilling and fun adventure with Conquer The Canyon.

THANK YOU and WELCOME!

Conquer The Canyon Initial Hiker Registration Form

1) Your Full Name
2) Your Email Address
3) Your Telephone
4) Have you read the online Training and Preparedness Manual?	Yes No
5) Have you read the online Trail Descriptions?	Yes No
6) When comparing yourself to your friends and co-workers, how would you categorize your fitness level?	Extremely Fit More Fit Average Not Fit
7) In minutes, how long does it take you to hike 5-kilometers on a level - smooth surface?
8) Have you exercised prior to training for Conquer The Canyon?	Yes No
9) If yes, what did you do?
10) Have you hiked a trail prior to training for Conquer The Canyon?	Yes No
11) If Yes, how often did you hike?	Daily 1 - 3 times a week Weekly 1 - 3 times a month Monthly Occasionally Rarely
12) What is the longest hike you have completed in the last 3 years?
13) Have you ever hiked Grand Canyon?	Yes No
14) If Yes, which trail(s)?
15) Have you ever been active above 2000 meters?	Yes No
16) If Yes, Negative Effects
17) Which do you find more difficult?	Going Down Hill Going Up Hill Both Neither
18) Have you ever experienced problems with heights?	Yes No
19) Do you have any problems, conditions, diseases or allergies we should know about?	Yes No
20) If Yes to any, please provide specifics.
21) Have you ever hiked with an organized group before?	Yes No
22) Have you ever hiked in a group on a professionally guided hike or tour?	Yes No
23) If Yes to either, what did you like or dislike?
24) How long do you plan to hike while at Grand Canyon?	1-2 Hours 3-4 Hours 5-6 Hours 7-9 Hours Longer
25) What is the most important aspect of your mission celebration hike while at Grand Canyon? (Check all that apply)	Hike with friends and training partners? More interpretive adventure with stops to enjoy scenary, learn and take pictures? Faster pace hike in and out of canyon?
26) Have you ever participated in a Team Diabetes Event?	Yes No
27) If Yes, Please list.
28) Will you be training with a friend(s)?	Yes No
29) If Yes, please list names and e-mails separated by a comma.
30) Is there a friend or training hiking partner you prefer to hike Grand Canyon with?
31) Trail Selection - Please make your initial Trail selection NOW, YOU can change it in the future.	Rim Trail Rim Trail w/Bright Angel Bright Angel 3-Miles Bright Angel 6-Miles Bright Angel - Indian Gardens 9-Miles Bright Angel - Plateau Point 12-Miles Hermit Trail
32) Do you have any questions or comments about the trails?
33) General Comments/Questions
34) Have you received a Conquer The Canyon Printed Registration Form?	Yes No
35) Have you read, signed & returned it to Team Diabetes?	Yes No
36) Are you interested in extending your stay with additional active adventures while in Arizona?	Yes No
37) If yes, please indicate your preference(s).	Additional Hiking in Grand Canyon Colorado River Float Horseback Riding Extended Backpacking Trip Helicopter Sightseeing Extension to Hiking in Sedona

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Have a safe and rewarding adventure!

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