If necessary please refer back to the Program Plan Template for your specific programWho is filling out this form?*-JackJackieMartinaMichelleNatashaOliviaSonjaZackOtherOther:*When did you work?* MM slash DD slash YYYY What type of program did you work (check all that apply)?* Challenge Course Mobile Team Building Cottage Reservation Other Other*Were you Lead facilitator on this program?* Yes No Have you updated your course plan?* Yes No Did you text or call Zack when the experience/program was over?* Yes No (not required if Zack was present at the program)Please find your course plan linked on the Fall 2016 ScheduleGroup and ParticipantsProgram Plan ID # (found on program plan template ID#)*Group Leader - Feedback (positive & negative)*Group Participants - Feedback (positive & negative)*Additional comments about group/participantsDid any incident occur during your program?* Yes No Was an incident report finished and filed?* Yes No Here is a copy of the Incident Reporting FormWhat was the final number of participants at the program?*Have you sent a follow up communication to the group contacts?* Yes No Were photos taken?* Yes No By who?*Co-Facilitators working the program.Co-Facilitators (Ctrl+click for multiple)*-JackJackieMartinaMichelleNatashaOliviaSonjaZackOtherOther:*Facilitator Feedback of Other Facilitators*Please provide specific feedback/shout outs to the facilitators you worked with on this program. Facilitator Feedback of Self*Please provide specific feedback about your own facilitation today. What did you excel at? What do you need to work on/practice more? Challenge CourseGeneral Feedback of Challenge Course Program*What went well for the group? What didn't? If the group were to come back for another program next semester/year what should we do differently?Physical Course Comments*Any maintenance needed or things we should know before our next program? Required elements were taken down and stored in their proper location* Yes No All items used for activities stored in their proper location?* Yes No Why not?*Team BuildingGeneral Feedback of Team Building Program*All items used for this program are stored in their proper location?* Yes No Why not?*Cottage ReservationGeneral Feedback for this Cottage Reservation*Any supplies running low* Yes No Which one(s)?*HikeGeneral Feedback of Hiking Program*All items used for this program are stored in their proper location?* Yes No Why not?*Land NavigationGeneral Feedback of Land Navigation Program*All items used for this program are stored in their proper location?* Yes No Why not?*General FeedbackAny additional comments?* Yes No Additional commentsEmailThis field is for validation purposes and should be left unchanged.