Participant Application

ALL applications are subject to final approval by BOEC Program Staff. Completing this application DOES NOT guarantee you a spot in a program. Please read our enrollment guidelines for winter or summer before applying to ensure participation is right for you. If you have further questions regarding eligibility, please call our office (970)-453-6422.
Program Interest
Camp Preferences

Frozen Assets Adaptive Ski Program: January 22-26, $1,940
Challenge by Choice #1: June 16-21, $2,390
Challenge by Choice #2: July 28- August 2, $2,390
Challenge by Choice #3: August 11 – August 16, $2,390
Ruby Horse Thief Canyon Canoe Excursion August 26-30 $1450
Creative Minds: September 13-16, $1290

*If scholarship assistance is needed for any of the BIAC opportunities listed below please contact Michael at  Please note, this application does not guarantee you a spot in your preferred camp.  Please check with Michael to see about availability.   

Applicant Information

   (Primary contact for all BOEC programming)
Please add Primary Emergency Contact Information (Parent, Guardian, Caregiver, etc...)
Please add the contact information for any additional contacts for this applicant. (Please, add all that apply)

Medical Insurance

Please note: We recommend that all BOEC students be covered by personal health insurance. If medical care for injury, pre-existing condition or any other reason is required during a BOEC course, the student’s personal health insurance will be primary.

Armed Forces

Disability/Medical Information

Medical History



Medical Conditions

Mobility Information



Activities of Daily Living



Files and Attachments
Comments, Questions, or Concerns

Application Acknowledgement
The Breckenridge Outdoor Education Center is committed to offering quality outdoor education to people of all abilities. All prospective students are required to fill out this student application. The above information assists the BOEC in maintaining a risk managed environment. Not completing this form as accurately and truthfully as possible, providing misinformation, or leaving out certain information could result in an injury or may compound the severity of an injury.  This information will be kept confidential.  We reserve the right to screen all students and may request that you provide a personal caregiver to join the program.
BIAC Application Fees
Note: All participants must include a $100 registration fee with the application, which is non-refundable. Upon
acceptance of the participant’s application, ½ of the participant fees are due. The remainder is due 30 days
prior to the program’s start date.

The $100 deposit can either be paid 
1. by check and sent to:

Brain Injury Alliance of Colorado
1490 Trenton St.
Denver, CO 80220

OR 2. online by credit/debit card.

To pay with card please contact at or 720-907-1455.

Please note that the applicant is not enrolled until the online application, online waiver, doctors form and $100 deposit have been received.

Upon submission, you will be redirected to complete our Release of Liability and Statement of Informed Consent documents.  These must be signed on the applicant's behalf in order to participate in a BOEC program.