Apply for Wild Ops Online

Thank you for your interest in Wild Ops. Please fill out the application form below to apply. Be advised this can take over 15 minutes to complete, so allow yourself adequate time. We recommend filling the form out on a computer and not on a mobile device.

Please be ready to attach digital copies of the following documents:

Redacted copy of Member-4 DD214 or current LES
Copy of Current Driver’s License or Federally Issued ID
Current Photo (so we can recognize and greet you at the airport)

(A separate application is required for each Operation you are applying for)

Veteran Information

First Name

Middle

Last Name

Preferred Name

Birthdate

Phone

Street Address

City

State

Zip

Spousal Information

Marital status*
SingleMarriedDivorced

Spouse Name

Phone

Emergency Contact

(If different from spouse)

Emergency Contact Name

Relationship

Phone

Medical Information

Primary Physician

Phone

Address

City

State

Zip

Medications (List all current prescribed medications)

Medication #1

Purpose

Medication #2

Purpose

Medication #3

Purpose

Medication #4

Purpose

Medication #5

Purpose

Physical Limitations
Please list any physical limitations and special accommodations needed

Allergies
List all environmental, food, and medical allergies

Have you ever experienced an anaphylactic allergic reaction?*
NoYes

If yes, do you carry an EpiPen?
NoYes

Do you have any dietary restrictions?

Military History

Branch of Service

Dates of Service

Start:

End:

Deployments/Combat Experience (Units, Dates, Locations)

Injury Information

Date of Injury

(if date unknown, please explain why)

List injuries with Brief Description

Are you currently employed?*
NoYes

Character References

First Reference

First Name

Last Name

Relationship to Applicant

Phone

Second Reference

First Name

Last Name

Relationship to Applicant

Phone

How did you hear about us?

APPLICATION ACKNOWLEDGMENTS:

(Please Initial each acknowledgement)*

I certify that the above answers are true to the best of my knowledge

If selected for an event, I agree to a $150 “hold my spot” deposit.

I understand that my $150 deposit is nonrefundable if I fail to attend or cancel less than 30 days prior to execution of the Operation.

I will participate in the Operation by reading/listening to Wild at Heart, the book, prior to the trip and respectfully engaging in discussions and activities throughout.

Who filled out this application?*

Date Applied

Printed Name*

DOCUMENTS REQUIRED FOR APPLICATION:

Redacted copy of Member-4 DD214 or current LES
Copy of Current Driver's License or Federally Issued ID
Current Photo (so we can recognize and greet you at the airport)

Redacted copy of Member-4 DD214 or current LES:

Copy of Current Driver's License or Federally Issued ID:

Current Photo (so we can recognize and greet you at the airport)

Apply Online for Wild Ops

Apply for Wild Ops Online

Veteran Information

Spousal Information

Emergency Contact

Medical Information

Medications (List all current prescribed medications)

Military History

Injury Information

Character References

First Reference

Second Reference

APPLICATION ACKNOWLEDGMENTS:

DOCUMENTS REQUIRED FOR APPLICATION: