Child's Information
Name
*
First Name
Last Name
Age
*
Gender
*
Boy
Girl
Has your child attended our Bug Camp before?
*
Yes
No
Shirt Size
*
Youth X-Small
Youth Small
Youth Medium
Youth Large
Camp Preference
We will be producing a documentary during the two Willow Bend camps, please let us know if you have concerns about your camper(s) being in the documentary,
Please confirm which Bug Camp your child will attend. You can select more than one camp in case your preferred camp is full.
*
Primary Parent/Guardian Information
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Primary Phone Number
*
-
Area Code
Phone Number
Secondary Phone Number
-
Area Code
Phone Number
E-mail
*
example@example.com
Emergency Contact
Name
*
First Name
Last Name
Relationship to Child
*
Primary Phone Number
*
-
Area Code
Phone Number
Secondary Phone Number
-
Area Code
Phone Number
E-mail
*
example@example.com
We will film a short documentary for the July camps. The Camp may use any photos in which my child appears for purposes of camp promotion:
*
Yes
No
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Program Health Form
Date of Birth
*
-
Month
-
Day
Year
Date
Immunizations are Current
*
Yes
No
Allergies
*
None
Hay Fever
Insect Stings
Asthma
Food
Other Allergies (please explain):
Medications
*
Yes
No
if yes, please list the types of medications for yourdependent below.
Any known health conditions, behavior conditions and/or disabilities?
*
Yes
No
if yes, please explain and indicate if any assistance or accommodations are needed.
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Bug Camp Policies
Refund & Credit Policies
If you wish to cancel your camp registration, you can contact Neil Cobb at 928-607-4075 or neilscobb@gmail.com The following policies and timelines apply. If you notify us one week or more before the camp your child is currently enrolled in, you can apply for full refund minus a $25 admin fee. If you notify us one week or less a refund is not guaranteed. If we fill your child’s spot a full refund will be granted minus a $25 admin fee. Once a program begins, we can not make any adjustments or offer any credits.
CAMP CONCERNS
At Bug Camp we strive to teach the campers about all aspects of entomology; from collecting insects, pinning insects, taking care of live bugs, learning and doing experiments.Two key issues have emerged that we would like to address below. Pet Cockroach: While we have never had a problem with campers wanting to keep their camp pet cockroach, parents of the campers are usually hesitant. We provide the campers with either Madagascar Hissing Cockroaches or Orange Head Cockroaches to take home with them at the end of camp if the parent allows. Both are non-native to the United States and if escaped would not survive on their own. They are fruit feeders and do not carry any diseases. These insects are very safe, fun and low maintenance pets to have and the campers just adore them. If at any time you no longer want your pet you can bring them back to the lab, and we will gladly take them back. Collecting,Pinning & Killing Insects: Collecting insects is a large part of what an entomologist does. Unlike mammals and birds it would be impossible to tag and recapture insects to properly study them. During camp we share these collecting techniques with your children. As part of this process proper methods of humane killing of insects is taught early on in the program by freezing them. Because insects are ectothermic, freezing them allows them to feel no pain. For the entomologist, killing an insect is the only way to document biodiversity, and it does not impact the population of an insect species. While local collecting has no impact on overall insect populations, habitat deforestation can. Children will be taught that some insects are habitat sensitive and we do not allow participants to collect those insects. (i.e. Monarch butterflies). Another thing to remember is that adult insects live a very short time as most of their life is spent in the larval stage. By the time children have collected them they have already lived 90- 99% of their life. Collecting and curating insects is a large part of our camp. Please talk to your child and if they are not comfortable with this process please do not register them for this camp. We find if the child is uncomfortable with this process they will not enjoy the camp as much and could create a negative camp experience for others.
DISCIPLINE POLICY
Bug Camp staff uses positive reinforcement techniques providing constructive and logical redirection of children to more acceptable behavior. This eliminates potential problems and encourages appropriate behavior rather than comparison, competition, or criticism. Consistent and clear rules are established. Staff members encourage children to solve problems rather than imposing solutions and help children to recognize and respect one another’s feelings. Counselors encourage pro-social behavior such as cooperation, helping, taking turns and constructive verbal communication to solve problems. Bug Camp reserves the right to dismiss a child for consistent behavior that makes it difficult or impossible for the staff to meet his/her needs and/or the needs of other children in the group. This will occur without a refund (or portion thereof). This will occur only after parent/staff discussion has occurred.
ELECTRONICS & TOYS
Bug Camp strives to provide a program free from video games,cell phones, audio players, toys and other distractions. Please do not permit your child to bring any of these items to camp as they will be busy throughout the camp day and these items also tend to get lost or misplaced when brought to camp.
I have read/agree with the above policies
*
Yes
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Payment
Your registration is not complete until we receive payment.
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PARENT/GUARDIAN'S AUTHORIZATION The child or children herein described has permission to engage in all camp activities (unless otherwise noted). If any medications are required during the time the child is at camp, it will be administered by Bug Camp staff. Absolutely NO tobacco, liquor, or illegal drugs will be brought, used or possessed during the session(s). If a child is removed by parent or guardian,dismissed from camp for disciplinary reasons, or for actions/behaviors incompatible for participation, no refund will be made or equivalent time given. If asked to leave, I understand the child must depart the program as soon as possible, and I (the parent/guardian) will arrange for such transportation at my sole expense. If the child is asked to leave for disciplinary reasons, I understand that the child may not be allowed to attend a future session. I have read and agreed to the terms in this application.
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( X )
Bug Camp Fee
$
350.00
Quantity
1
2
3
4
5
6
7
8
9
10
Price for Willow Bend or Museum of Northern AZ Member
$
325.00
Quantity
1
2
3
4
5
6
7
8
9
10
DONATION (is in addition to program fee)
$
10.00
Your donation helps support children attend the camp who cannot afford to pay the full amount! Biodiversity Outreach Network is an Arizona nonprofit corporation with 501(c)(3) status.
Donation amount
10.00
15.00
25.00
50.00
75.00
100.00
Total
$
0.00
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