Apply Your Contact InformationName First Last Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneEmail Date of Birth Date Format: MM slash DD slash YYYY Emergency Contact InformationName First Last RelationshipPhoneYour Military InformationRate / RankMOSBranchChoose branch of militaryArmyAir ForceCoast GuardMarinesNavyStill Active DutyStill Active Duty?YesNoCurrent Duty StationDo you have a DD214?Do you have a DD214?YesNoBriefly explain why you do not have a DD214 and can you get a copy of yours?If separated from the military did you receive a Honorable Discharge?Honorable Discharge?YesNoBriefly explain why you did not receive an Honorable Discharge?Do you have:Check all that apply PTS (Post Traumatic Stress) TBI (Traumatic Brain Injury) Stress Trauma Are any of these conditions a result of military service?Choose yes or noYesNoPlease tell us about your notable military experiences, deployments-include dates, training, schools, awards, citations, etc.Health InformationDo you have any medicine allergies?Choose yes or noYesNoPlease list medicine allergies:Do you have any food allergies?Choose yes or noYesNoPlease list food allergies:Outdoor Adventure InformationDo you have any limitations, mental or physical, that will require assistance? If so, what type of assistance will you need? If a personal handler is part of your regular routine, we encourage their participation. We are able to accommodate any level of injury on some of our adventures, paraplegic and quadriplegic, wheelchairs are ok. However we must know any personal limitations in order to properly plan your event, which may include rigorous outdoor activityWhy would you like join Tadpole Foundations Outdoor Adventures? Please tell us about your outdoor experiences, if any. What do you hope to gain from joining Tadpole Adventures? It is not a requirement that you have participated in the outdoors but whatever your experience level, please tell us why you are interested. Don’t be shy we want to know your story.Which Adventure(s) are you interested in?You may choose as many as you like. Eastern High Sierra Big Pine Lakes early May Montana Beartooth Mountains mid June SW Montana Navy SEALS TG Only, location & dates provided privately Eastern High Sierra Hungry Packer Lake First Responders Only Early September Eastern High Sierra Outside Yosemite 20 Lakes Basin Mid September LimitationsBy honestly answering these questions we will be able to help ensure that you have an incredible experience on your adventure.Are you comfortable hiking at high elevations (above 10,000 feet)?Choose yes or noYesNoAre you comfortable and able to hike 7 or more miles a day?Choose yes or noYesNoCan you carry a 45lb pack while hiking 7 miles?Choose yes or noYesNoAre you comfortable sleeping in a tent in the backcountry?Choose yes or noYesNoIf you answsered no to any of the questions, briefly explain why. This will allow us to make your adventure as enjoyable to you as possible.Do you have a service dog that you would want to bring with you?Service dogs are only allowed on certain trips.Choose yes or noYesNoTadpole Foundation also has a Veteran Equestrian Program where we offer horseback riding and horsemanship once a month. It is free to attend and lunch is always provided. Location is in Norco, CA at the Norco Equestrian Academy the first Sunday of each month. Are you interested in attending?Choose yes or noYesNoAnything in addition you want us to knowPlease upload a copy of your DD214 if discharged from the military, or a copy of your ID card if active duty. Drop files here or Please mark out/hide social security numbers and/or ID card numbers.CommentsThis field is for validation purposes and should be left unchanged. Apply This iframe contains the logic required to handle Ajax powered Gravity Forms.