CHANGING SEAS FOR HIGH SCHOOL STUDENTS - June 30

CHANGING SEAS FOR HIGH SCHOOL STUDENTS

June 30 - July 3, 2025 from 8:30am - 3:30pm

Maine Residents: $450

Non Maine Residents: $500

This experiential camp is designed to focus on changing seas and how Maine’s marine economy is impacted. Topics include ocean plastics, rising sea level, warming waters and sustainability.

Field trips to local and regional businesses will be a prime feature of this week. Participants will be able to observe and gain insight from professionals currently working in coastal trades. Students will use scientific instruments both in the field and in the lab. Students will board a 55’ Ketch out of Rockland harbor to gather samples and data from the Penobscot Bay. We plan to kayak to an oyster farm in Muscongus Bay and speak with the farmers about the benefits of the work that they are doing.

Transportation is available from the Knox Museum side parking lot

STUDENT NAME*

First NameLast Name

PREFERRED PRONOUNS

She/her/hersHe/his/himThey/them/theirs

CURRENT GRADE AND AGE*

GradeAge

DATE OF BIRTH*

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, psychiatric, 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): Snacks and lunches will be provided. Please indicate IF the student has food or environmental 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, 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.

Students will be picked up and dropped off at a centralized location that will be determined by home addresses of participants after they have registered.

Signature*

DROP OFF / PICK UP INFORMATION

Drop-off is at 9am and Pick-Up at 3:00pm at the Herring Gut Coastal Science Center’s main building. The address is 59 Factory Road in Port Clyde. Our phone # is 207-372-8677.

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 with respect to copyright ownership and publication including any claim for compensation related to use of the materials.

You may not use images of my child

Authorized people to pick-up my child:*

I would like scholarship information

YES

PAYMENT OPTIONS*

Changing Seas - DepositDeposit is non refundable after April 1, 2025. Balance to be paid in full by May 15, 2025

$100.00 Quantity

Changing Seats - Maine Resident Product Image

Changing Seats - Maine ResidentFull Payment

$450.00 Quantity

Changing Seas - Non Resident Product Image

Changing Seas - Non ResidentFull Payment

$500.00

Total

$0.00

Payment Methods

Debit or Credit Card

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