First Descents Participant Inquiry Form

Please note that we are only accepting inquiries for oncology specific programs at this time. If you are have questions about MS specific questions, please email msprograms@firstdescents.org.

What is your Birthdate? (month/day/year)

Age

Under 1818-3940-4546+

*Please note that you do have to be at least 18 years or older to attend a program and diagnosed at or after the age of 15.

*At this time we do not provide programs for individuals over the age of 45.

What age were you diagnosed.

Under 15Over 15 and under 39Over 39

*Please note. We give priority the clinical young adult demographic age 18-39. If you were diagnosed in this age range, but are now between the ages of 40-45, we will allow you to attend if spaces become available.

***Please note that at this time our programs are open to participants diagnosed in the clinical Young Adult demographic of 18-39.***

Have you experienced any relapse or treatment since your 15th birthday?

YesNo

*Please note that you do have to be at least 18 years or older to attend a program and diagnosed at or after the age of 15.

General Information

Please note, with this information we will only contact you about program related opportunities. By filling this out, you will be entered into our database, and we will reach out to you when we start filling our programs in the spring.

First Name

Last Name

Email Address

Phone Number

Street Address

City

State/Province

Zip Code

What date were you diagnosed?

How do you identify your gender?

MaleFemaleTransSelf Identified

First Descents Age Requirement

At this time FD primarily young adults who are currently over 18 years of age and who were diagnosed between the ages of 15-39. If you have questions about this or are a young adult survivor of pediatric cancer and would like more resources, email programs@firstdescents.org or call the main office at (303) 945-2490 Extension 1 for programs. We'll introduce you to some programs for pediatric survivors that come highly recommended!

First Descents Age Requirment

At this time First Descents primarily serves young adults diagnosed between the ages of 15-39. We do accept participants over 40 if they were diagnosed within this age range and are within 5 years of their diagnosis. If you fall out of these age ranges, we would be happy to provide you with resources for similar programs. Email programs@firstdescents.org or call the main office at (303) 945-2490 - Ext 1 for more information.

Almost there!

With the exception of our Ice climbing Programs, which we will open in the Fall, we will reach out to participants individually in the spring based on when everybody submitted this inquiry (first come, first serve). Would you prefer us to contact you by phone or email?

PhoneEmail

Just out of curiosity, what type of program drew you to First Descents? (you can check more than one if you like)

The weeklong adventuresThe shorter tributary adventures close to home I just googled "free stuff if you have cancer"

If you have any questions about our programs, feel free to check this box to receive a call from us in the next couple of days.

Sure, give me a call

Were you referred by one of our Alumni? If so, let us know who so that we can thank them! (full name would be great if you know it)

Thanks for taking the time to fill this out! All you have to do now is submit and you'll be eligible for our programs. Again, we'll be in touch in the spring about program openings, but in the meantime be sure to check out your local FDtributary for shorter adventures with other young adults with cancer in your area. As always, if you have any questions, feel free to reach out to programs@firstdescents.org or call us at the office 303.945.2490.

*In order to ensure that our emails do not go into your spam folder, please add programs@firstdescents.org to your contacts.