NATURAL RESOURCE CAMP July 16-20, 2018 Camp Registration Form. Year in School (circle one) Freshman Sophomore Junior Senior ( school year)

Transcription

1 CAMP ATTENDEE INFORMATION NATURAL RESOURCE CAMP July 16-20, 2018 Camp Registration Form Name Year in School (circle one) Freshman Sophomore Junior Senior ( school year) Gender (circle one) Female Male (This information is needed for housing purposes) Address City, State, Zip Code Phone Number (please write clearly) REGISTRATION INFORMATION $300 Registration Fee The registration fee includes meals, housing, and a camp t-shirt. Gatorade and water will also be provided. The field station bunkhouse consists of two large bunk rooms (male and female quarters) and a central commons area. The field station also has a shower house, outdoor and indoor sinks, flush toilets and outhouses, and a dining hall. Two camp counselors and the camp coordinator will be on-site at all times to supervise student activities. Several camp activities leaders will also be present throughout most of each day. Space is limited to 25 males and 25 females and is available on a first-come, first-serve basis. A non-refundable $75 pre-registration deposit must accompany your registration form. The $75 pre-registration fee will be deducted from your total registration fee. The remaining portion of your registration will be due prior to or upon your arrival at camp. Your registration will be confirmed using the address provided above. Please register by May 31, Please include any food allergy information: Adult Shirt Size: S M L XL XXL Permission of parent or guardian to attend camp is required. Signature of Parent/Guardian Date Please send this form and payment to: Natural Resource Management, SDSU Attn: NR Camp Coordinator Box 2140B Brookings, SD Checks payable to NRM SDSU Questions? us at SDSU.NRM@sdstate.edu or call us at of 5

2 MEDICAL EMERGENCY FORM AND WAIVER and do not provide insurance coverage for participants of Natural Resource Camp. Your family medical coverage must be used in case of an emergency; therefore, your medical information is required to attend and participate in Natural Resource Camp. Emergency facilities are located in Hendricks, MN only 10 minutes from the field station. PLEASE COMPLETE THE FORM BELOW. THIS INFORMATION WILL BE USED IN THE EVENT OF A MEDICAL EMERGENCY. The name of your medical insurance company, name of policy holder, and policy number: Is your child allergic to any medications, plants, foods or other items that they may come in contact with during Natural Resource Camp? yes no o If yes, please list allergies? When was your child s last tetanus shot? Is your child being treated for any existing conditions or chronic illnesses? yes no o If yes, what medication are they taking, how much and how often? Do we have your permission to take your child to emergency medical facilities should they be required? yes no Emergency contact name and phone number Damages Waiver I, intending to be legally bound hereby for myself, my heirs, executors, administrator, waive and release any and all rights and claims for damages I may have against or its representatives and/or assignees with my child s entry in the Natural Resource Camp, and which may arise out of my traveling to or participating in, and returning from the Natural Resource Camp. Signature of Parent/Guardian Date 2 of 5

3 PHOTO RELEASE AUTHORIZATION I, (parent or guardian name) hereby authorize South Dakota State University to photograph (camp attendee s name) and authorize South Dakota State University the absolute right and unrestricted permission to publish and/or use such photographs for use in any of its publications and/or promotional materials. Signature (of parent or guardian if under 18 years of age) Address City/State/Zip 3 of 5

4 CAMP RULES AND POLICIES The 2018 Natural Resource Camp is held at in Astoria, SD. The is a 570-acre facility located in the heart of the Northern Plains on the Coteau Des Prairie. Oak Lake Field Station is a university-owned facility managed by the at South Dakota State University. Campers are expected to adhere to all University policies, regulations, guidelines, and all local, state and federal laws. Campers are also expected to act in a professional manner and follow the Field Station and Camp Policies, outlined below. This document describes consequences (in italics) of violating any of these policies. 1. State and federal laws: a. Including, but not limited to: i. Possession of illegal substances ii. Assault iii. Theft iv. Unauthorized taking of plants and animals (The term 'take' means to harass, harm, pursue, hunt, shoot, wound, kill, trap, capture, or collect, or to attempt to engage in any such conduct.) b. If a camper is involved in any illegal activities or violates any state or federal laws, local law enforcement and the parent/guardian will be contacted. Illegal activities will result in immediate dismissal and no refund will be provided. 2. University and policies a. The following items are prohibited: i. pets ii. fireworks iii. alcohol and/or illegal drugs iv. weapons, including, but not limited to: 1. center or rim fire firearms (including BB guns, pellet guns, shotguns, rifles, pistols or any other tool intended launch projectiles with the purpose of target shooting or hunting animals) 2. knives 3. compound, crossbow, long or recurve bows b. The following activities are prohibited: i. hunting ii. removal or modification of vegetation (except for authorized camp activities) iii. campfires in non-designated areas (the middle of the camping area is the only designated area) iv. digging holes, taking samples, kill/harm/remove animals (except for authorized camp activities) v. littering vi. release of chemicals or other potentially hazardous materials vii. storage of chemicals or hazardous materials in the dining hall 4 of 5

5 c. Campers are expected to keep the field station facilities clean. Students must clean up after themselves, including, but not limited to: i. washing, drying, and putting away dishes ii. cleaning countertops, table tops, and sinks after meals iii. sweep floors if a mess is made iv. clean and return equipment and classroom supplies d. The consequence of violating any University and/or Field Station policies is dependent upon the severity of the infraction and is at the discretion of the Camp Coordinator and Field Station Director. Any illegal activities will be handled according to 1.b. in this document. For other violations, campers will be given a warning. If campers repeatedly violate these policies or the infraction is severe, campers will be asked to leave the field station for the remainder of camp with no refund. Parents/guardians will be contacted. 3. Camp Policies a. Campers will not be permitted to leave camp once they arrive. b. All personal vehicles must be parked in the designated parking area near the Administration building and kept there during the duration of camp. c. Campers will not be permitted to leave the living area (bunk house, camping area, and nearby restrooms and sinks) after 10:00 pm (unless involved in a scheduled camp activity). d. Lights out will be at 11:00 pm (unless involved in a scheduled camp activity) e. Apparel and other items that depict alcohol, drugs, or mature content are prohibited. f. Campers should be respectful to each other and anyone at the Field Station. Campers should not bully, harass, or discriminate against other campers, nor should they disrupt camp activities. g. The consequence of violating camp policies is dependent upon the severity of the infraction and is at the discretion of the Camp Coordinator. Campers may only be given a warning. If campers repeatedly violate these policies, campers will be asked to leave the field station for the remainder of camp with no refund. Parents/guardians will be contacted. I have read and understand the aforementioned policies and consequences of violating those policies. (Name of Camper Please print) (Name of Parent or Guardian) Date: (Signature of Parent or Guardian) 5 of 5