Name of volunteer or rider:

Rider contact name:

E-mail:

Phone:

recieve texts?
yes no

City/State:

Best time to contact:

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Program Fees:
- $300 for Free Flight
- $1,000 plus Travel for Tethered Ride Event

Choose your adventure:
Free flight - All hot air balloon free flights on Dream Catcher are for 30 minutes and take place in Sequim, WA at altitudes of 500' to 2500' above ground level. Weather restrictions apply.
Tethered ride - Tethered rides in Dream Catcher are available at most locations with advance site inspection approval. Weather restrictions apply.

Choose one:
I am not disabled and I weigh less than 200 pounds with no physical limitations for a flight up to 2500 feet above the ground.
I am mobility challenged.

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Free fly parameters, check all that apply:

I need oxygen
I have PTSD
I need a care giver to communicate
I need assistance transferring myself to the seat on the balloon
I need assistance breathing
I have high blood pressure
I have heart trouble
I have neck trouble
I have back trouble
I weigh 200 lbs or more
I can be away from my care giver for 30 minutes
I smoke cigarettes
I am pregnant - If so how far along?
Have you had a recent surgery? If so please explain:

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