Free Youth Camp Ages June 24 th -28 th
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1 Free Youth Camp Ages June 24 th -28 th A cost-free week of overnight Rafting, Backpacking, Snorkeling, Fisheries Restoration, Outdoor Survival Skills, Kayaking, Paddle Boarding and much more to share with other youth from up and down the Klamath River!!!!! Apply Today!!!!! Limited Spaces Open Backpacking and Camping Equipment Provided by request Contact the Mid Klamath Watershed Council (530) or jillienne@mkwc.org
2 Mid Klamath Watershed Council P.O. Box 409, Orleans, Ca Tel: (530) Fax: (866) Klamath-Siskiyou Outdoor School The Klamath-Siskiyou Outdoor School (KSOS) is a cost-free camp for local youth in the Mid Klamath region to participate in a week of restoration rafting and backpacking trips as well as implement environmental service projects in the Klamath River watershed. Klamath Siskiyou Outdoor School Agenda (Tentative) Monday June 24 th : Orientation and Rafting (Persido to Stuarts Bar) Raft Trip w/fisheries Restoration Snorkeling and Fish Identification Special Presentations Interactive Games Natural Resource Career Presentations Environmental Film Night Tuesday June 25 th : Kayaking and Paddle Boarding Prepare packs for backpacking trip Kayaking at Otter Bar Intro to Stand Up Paddle Boarding Interactive Games and Special Presentations Arts and Crafts (T-shirt making) Wednesday June 26 th : Backpacking in the Trinity Alps Wilderness (Long Gulch Lake) Begin Backpacking Trip Invasive weed monitoring and removal Counselor lead workshops
3 Thursday June 27 th Backpacking Trip to the Trinity Alps Wilderness Shelter Building and Survival Skills Day Hikes Fishing Counselor Workshops Friday June 28 th Depart Trinity Alps Wilderness Hike out of Wilderness Clean Forks Community Club Closing Ceremony at George Geary Backpacking Equipment can be provided upon request. If you are interested in attending please return this application packet to the Mid Klamath Watershed Council office at the Panamnik Building or call (530) KSOS Counselor and Participants read the map while breaking at Haypress meadows (above). Students learn how to identify and remove local invasive weed populations. (below)
4 Mid Klamath Watershed Council P.O. Box 409, Orleans, Ca Tel: (530) Fax: (866) Klamath-Siskiyou Outdoor School (KSOS) Student Participant Information Name of participant(s): Address: Phone: Health Concerns: Are there any health concerns staff should be aware of in working with your child (allergies/medications/etc) Emergency Contact Information: Name: Phone: Relationship: Name: Phone: Relationship: Medical provider : Phone: Insurance or Medi-Cal #: I give permission for activity staff to seek medical treatment for my child. Signed: My child has permission to participate in the MKWC Klamath-Siskiyou Outdoor School. I understand that I release all liability for any loss, damage, or cost that may incur in the event of injury or damage while participating in KSOS activities. Parent/Guardian: Date: Private Vehicle Transportation: I give permission for my child to be transported in approved private vehicles for KSOS activities. Parent/Guardian: Date:
5 Klamath-Siskiyou Outdoor School Parental Release Form and Camper Agreements I have requested the Mid Klamath Watershed Council allow my child to participate in the Klamath- Siskiyou Outdoor School. As a condition of receiving this benefit, I, the undersigned, do hereby agree to the following: I understand that my child s participation can expose him or her to risks from known and unanticipated factors. Acknowledging that such risks exist, I hereby release and discharge the Mid Klamath Watershed Council and it s trip leaders from any and all claims of liability for personal injury or property damage my child may suffer while on this trip. Furthermore, in the event I cannot be reached in an emergency I hereby give permission to a physician selected by The Mid Klamath Watershed Council Leader to secure and administer medical treatment, including hospitalization, for my child. This medical care includes but is not limited to providing routine health care; administering over-the-counter and prescribed medications; ordering X-rays or routine tests; releasing any records necessary for insurance purposes; and providing related transportation for my child. I acknowledge that any extraordinary emergency fees may be borne by the camper s parent/guardian. I understand that I, the parent, and my emergency contact will be notified by a representative of the Mid Klamath Watershed Council if my child is required to be seen by a hospital or physician. Parent Name (Please Print) Date Parent Signature KSOS Wilderness First Aid Release Form The KlamathSiskiyou Outdoor School is dedicated to providing a safe, fun, and educational experience for your children. To make sure we are prepared for the trip, please take a moment to read and sign the below. I, the parent/legal guardian of, give permission to the counselors of the Klamath Siskiyou Outdoor School (KSOS) to provide emergency medical care if needed within the bounds of their training (CPR/First Aid, Wilderness First Aid, Wilderness First Responder, or Wilderness EMT) and according to accepted wilderness protocols. This care may include the reduction of simple dislocations; administration of ibuprofen, Benadryl, and EpiPen; and evacuation / spinal stabilization decisions. I understand that communication is limited in remote areas and that counselors will contact parents/guardians as soon as possible in an emergency. Signed Date
6 Camper s Contract of Understanding I understand that the Klamath-Siskiyou Outdoor School is an outdoor travel program where I will live close to the outdoors and to others who go on the trip. Campers and camp leaders sleep on the ground and work together in meal preparation and clean-up. I am aware that I will be hiking into the backcountry and that during these hikes I will help carry supplies such as food and my own drinking water. The Klamath-Siskiyou Outdoor School focuses on environmental restoration projects, backcountry living, and community service projects. I will not bring any of the following, nor use them while I am on a trip: electronic devices (ipods, tape recorders, CD players, radios, cell phones, games, etc.); pets or animals; weapons of any kind; alcohol; tobacco (cigarettes, cigars, snuff, etc.); fireworks; or illegal drugs. I know that I will be sent home for having or using these things at camp. I will try to make my trip with the Klamath-Siskiyou Outdoor School a safe and comfortable experience for all people. Additionally, I understand that this is an educational experience and I will actively participate in all camp activities. Camper s Name in Print and Signature Camper Essay In the space provided below, please state why you are interested in participating in the Klamath- Siskiyou Outdoor School. In the space provided below please write something unique, interesting, or odd about you that not many people would know. (Examples are Can put lipstick on with my toes, Have climbed to the top of Mt. Everest, Has seen Bigfoot, or Visited three different countries etc.)
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