WILDERNESS SURVIVAL CAMPOUT 2026 - Intake Form

There is some required information we need to know about you to ensure safety and avoid health risks. Please complete the following questionnaire and return it as soon as possible.

Participant Information

Emergency Contact Name

Emergency Contact Phone Number

Flight Information (For Flyers Only)

Please email us your itinerary to Karie@KarieLeeKnoke.com

What airline and flight# are you on?

What time do you arrive in Spokane?

What time do you depart from Spokane?

Do you have any dietary restrictions? If so, please specify which are absolute restrictions and which you prefer to avoid. We do our best to accommodate everyone's health needs.

Do you have any known allergies? If they are allergic to bee stings, do you have an EpiPen?

Do you take any medications daily? If yes, please list them.

Please provide information about your overall health and any health conditions that may affect their physical ability during this course.

What is your camping, hiking and outdoor experience level?

What is your experience background in wilderness activities?

Do you have any survival or first aid training in the past?

How would you rate your confidence level if you found yourself lost in the woods with little or no gear?

I know nothing and I'm sure I'm going to die.

I might survive for a few hours.

I could find my way home within 12 hours.

I could make it through the night easily.

I wouldn’t need to go home. I could live out here for a long time.

What is your T-shirt size?

Which rental gear would you like to reserve for the retreat? (Select all that apply.)

Terms and Agreements:

Be Kind and Courteous

- We're all in this together to create a Welcoming environment. Let's treat everyone with respect. Healthy debates are natural, but kindness is required.

No Hate Speech or Bullying

- Make sure everyone feels safe. Bullying of any kind isn't allowed, and degrading comments about things like race, religion, culture, sexual orientation, gender or identity will not be tolerated.

Respect Everyone's Privacy

- Being part of this group requires mutual trust. Authentic, expressive discussions make groups great, but may also be sensitive and private. What's shared in the circle should stay in the circle.

The Following Are Prohibited:

Weapons of any kind outside of workshops
Open fires outside of designated fire areas
Outside alcohol
Fireworks
Professional audio or video recording equipment
Unauthorized/unlicensed vendors and solicitation
Illegal or illicit substances
Pets (unless approved in advance)

No Alcohol

- For safety reasons, especially with shooting and handling firearms, this is a no-alcohol event. Alcohol is not permitted on the premises.

Return Policy

- Emergencies happen and we fully understand. However, Due to the costs of securing instructors, staff, travel expenses and supplies, we need ample notice at least one month before the retreat starts. So, we offer this solution for you.

Cancellations before June 8th, 2025, will be fully refundable. However, you can opt-in for a credit for a future course, such as next year's Survival Sisterhood Retreat.

Cancellations after June 8th, 2025, will receive a 50% refund and 50% credit for a future course of your choice, minus $250. However, you can opt-in for more credit, instead of the refund, for a future course, such as next year's Survival Sisterhood Retreat.

Cancellations after June 30th, 2025, will not be refundable, however, we will issue a credit for a future course of your choice, minus $500, such as next year's Survival Sisterhood Retreat.

Thank you for helping us create a space where everyone feels supported and valued!

I Agree to the Tems & Conditions