Poplar Ridge Staff

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Name of contact person: *

Full Name
Today's date: *

/ /
Phone number: *
Email address: *
Billing address and contact person: *
Name and basic demographics of your group or organization: *
If applicable, please indicate any UVa affiliation your group has? *
Number of people expected for the program. Please note that final participation numbers can be confirmed up to 7 days before the date of the program. *
Please specify how you found out about us (website, previous experience, etc.). *

Are you interested in doing a half-day program (up to 4 hours) or a full-day program? Multi-day programs can be arranged as well. *

What style of program are you most interested in for you group (team building, high element initiatives, combination)? *

What date do you prefer for the program? *

What time frame do you prefer? We can run programs anytime during daylight hours. For the half-day programs on the weekend, we prefer to schedule them in the morning or afternoon rather than the middle of the day to accommodate more groups. *

Would you like us to book an indoor site as a contingency plan for inclement weather? If indoors, we use portable team building activities. There is no additional charge for this service. *

Security Code: *

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UNIVERSITY OF VIRGINIA INTRAMURAL-RECREATIONAL SPORTS
Aquatic & Fitness Center
450 Whitehead Rd., P.O. Box 400317, Charlottesville, VA 22904 Phone: 434.924.3791 Fax: 434.924.3858 Hotline: 924.PLAY Email: imrecsports@virginia.edu
Maintained by imrecsports@virginia.edu
© 2012 by the Rector and Visitors of the University of Virginia