JUNIOR MARINE SCIENTIST CAMP - Session 2: July 22-26, 2024 (Maine Resident)

JUNIOR MARINE SCIENTIST CAMP for Ages 11-13

NOTE: Students turning 11 by September 1, 2024 are invited to register.

Session 2: July 22-26, 2024 from 9:00 am - 2:00 pm

(Maine Residents)

During our Junior Marine Scientist camp, participants will gain a unique perspective on the marine environment surrounding Midcoast Maine. Junior scientists will conduct field experiments, explore aquaculture and aquaponics, and learn about the marine animals and ecosystems that make Midcoast Maine so unique.

Based on the location of program participants, we will identify two pick-up locations. (example: Medomack High School and Knox Museum)

THIS CAMP IS FULLY FUNDED BY THE MAINE OUTDOOR LEARNING INITIATIVE. THERE IS NO COST TO MAINE RESIDENTS TO ATTEND THIS CAMP.

This grant is intended to give as many students as possible a camp experience. Registration is limited to one program.
American Rescue Plan Act GEER, Reverted EANS Funding received from the USDOE support the implementation of this project. The project has an award totaling $6.6 million dollars of which 100% is federally funded and directly attributed to project implementation. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by the USDOE or the U.S. Government.

STUDENT NAME

First NameLast Name

GRADE AND AGE

GradeAge

SCHOOL

Student Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

PARENT / GUARDIAN

First NameLast Name

PARENT / GUARDIAN CONTACT INFO

PhoneEmail

EMERGENCY CONTACT

Full NameHome/Cell

Student safety and well being is our number one priority. All Herring Gut Staff are First Aid and CPR trained. Please provide accurate information about your student’s health so we can maintain our high safety standards while providing a fun and meaningful experience. This form needs to be filled out for all students.

Medication: The Herring Gut Coastal Science Center medication policy allows that individuals, enrolled in a program, may self-administer a prescription, including emergency medical devices, and over the counter medications during program hours. Individuals MUST be able to name and recognize their medication, and know the proper dosage and how to administer the medication. The first dose of any new medication must be taken 24 hours prior to attending any Herring Gut programs. All medications must be in the original pharmaceutical container, including asthma inhalers. Program staff will verify in writing the amount of medications they have accepted for an individual.

ON-PERSON MEDICATION:
Name of medication needed during program hours: .
Medication dose and side effects: .

Parent Signature for Medication

WAIVER TO CARRY EMERGENCY MEDICAL DEVICE
All emergency medical devices (i.e. inhalers and EpiPens) are to be carried on the individual’s person while attending programs.

Due to the potential necessity for immediate medication distribution imposed by my child’s life-threatening condition, I blanks hereby request that blank be allowed to keep the appropriate prescribed device on his/her/their person while participating in all Herring Gut activities.

The prescribed device:

Epi PenInhalerOther

HEALTH CONDITIONS: Are there any physical, behavioral, emotional, or developmental concerns staff should be aware of?*

YESNO

If yes, please explain:

Please let us know if any accommodations or precautions are needed to help your child succeed while at Herring Gut:

ALLERGIES (Food or Environmental): Any snacks or lunches should be brought from home/school IF the student has food allergies.*

YESNO

If yes, please list allergies:

Please read this form carefully and be aware that in consideration for the Herring Gut Coastal Science Center, you will be expressly assuming the risk and legal liability and waiving and releasing all claims for injuries, damages or loss which your child might sustain as a result of said transportation services, including but not limited to, vehicle operations and boarding and exiting the vehicle.

TRANSPORTATION RELEASE:

I recognize and acknowledge that Herring Gut Coastal Science Center is neither a common carrier nor in the business of providing transportation services to the public. I further recognize and acknowledge that there are certain risks of physical injury to vehicle passengers, and I voluntarily agree to assume the full risk of any injuries, damages or loss, regardless of severity, that my child might sustain as a result of participating in any and all activities connected with or associated with receiving transportation services, including, but not limited to, injuries, damages and loss arising out of negligent operation or supervision of the vehicle. I further agree to waive and relinquish all claims I may have (or accrue to me) against Herring Gut Coastal Science Center, including its respective officials, agents, volunteers and employees (hereinafter collectively referred to as “Party”). I do hereby fully release and forever discharge the Party from any and all claims for injuries, damages or loss that I may have or which may accrue to my child and arising out of, connected with, or in any way associated with said transportation services.

Signature*

DROP OFF / PICK UP INFORMATION

Drop-off is at 9:00am and Pick-Up at 2:00pm at the Herring Gut’s main building. The address is 59 Factory Road in Port Clyde. Our phone # is 207-372-8677.

Van transportation from the Knox Museum parking lot is available with an 8:30am pickp and 2:30pm drop off.

PHOTO RELEASE

Unless detailed here, I give Herring Gut Coastal Science Center permission to publish in print, electronic or video format the likeness or image of my child I release all claims against the Herring Gut Coastal Science Center with respect to copyright ownership and publication including any claim for compensation related to use of the materials.

You may use images of my childYou may use images of my child, but not use their nameYou may not use images of my child

Authorized people to pick-up my child:*

I acknowledge pick-up is at 2pm at Herring Gut's main building and 2:30 at Knox Museum parking lot*

CAMP DEPOSIT - NO LONGER REQUIRED FOR MAINE RESIDENT

Junior Marine Scientist Camp Product Image

Junior Marine Scientist CampDeposit

$50.00

Total

$0.00

Payment Methods

Debit or Credit Card

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Last Name

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Please click one of the PayPal options to complete payment and submit the form.