Team Challenge Reservation Form Group Name First Choice Date Please use the following format MM/DD/YYYY. Preferred Time Second Choice Date Please use the following format MM/DD/YYYY. Preferred Time Allocation of Time For example: 30 minutes, one hour, etc. Team Challenge Program Traditional Team Challenge Recreational Team Challenge Retreat Services Team Building Presentation Would you like to incorporate additional wellness activities? Ex. Zumba, yoga, deep breathing, etc. **Will include an extra charge Information related to group goals Number of Participants Group Type - None -ASU Student OrganizationsASU Faculty / Staff / DepartmentsASU Academic ClassesASU Programs (i.e. AECP or Barrett Honors) Participated in Team Challenge Before? - None -YesNoNot Sure Special Needs Special needs includes: recently had surgery, pregnancy, crutches, wheelchair, etc. Location - None -Downtown Phoenix PolytechnicTempeWestOff-Campus *additional fess may apply Location Designated If space previously reserved, please let us know here. Directions to Off-Campus Location Please provide location name, address and room location if applicable. Would you like to have a face-to-face meeting with a Team Challenge staff member to help plan your event? Yes No Will you need any of the following? Facility Setup (e.g., tables, chairs, etc.) Accommodations Media Services Additional costs may apply. Contact Name Department/College/Organization Name Email Address Phone Number