Creative Nature Academy Application

Summer Camp Application 2025

Welcome to Creative Nature Academy! Creative Nature Academy is the only nature-based education in West Michigan that takes students on a pilgrimage to their inner temples of leadership, creativity, and wonder, where the explorer within each child is honored, celebrated, and nurtured - accessed through gentle guidance into the wilds of Blandford Nature Center in the heart of Grand Rapids - a canvas where the spirit of adventure mingles with the whispers of the wild. We look forward to welcoming your child to Creative Nature Academy, where every day is an adventure in learning and discovery! If you have any questions or need assistance with the application process, please don't hesitate to contact us. We're here to help!

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Creek Quest (Ages 5-8) June 17-19 | 9:30 AM - 12:30 PM | Step into the Brandywine Creek Laboratory and become a STEM-powered nature engineer! Young explorers will dive into hands-on scientific investigations, testing buoyancy, speed, and strength to discover the best natural materials for building and racing their own boats. Through creek-side experiments, problem-solving, and creative engineering, campers will refine their designs and put their creations to the test in exciting water challenges. With mud and camouflage games, outdoor exploration, and nonstop adventure, this program blends STEM learning with nature play for an unforgettable experience!

$100.00

Forest and Music Quest (Ages 5-8) Product Image

Forest and Music Quest (Ages 5-8) July 15-17 | 9:30 AM - 12:30 PM | Young adventurers will become nature engineers and musicians, using natural materials to build woodland structures and handcrafted percussion instruments. They’ll build a forest drum forts, explore the music of the wild, and experiment with rhythm using logs, leaves, and handmade drums. Through hands-on building, drumming, and imaginative play, campers will blend STEM, creativity, and outdoor exploration for a one-of-a-kind experience!

$100.00 Quantity

Survival Quest (Ages 8-12) - Product Image

Survival Quest (Ages 8-12) - June 10-12| 9:30 AM - 2:30 PM | Step into the wilderness and master the skills of survival! Campers will explore fire science, shelter engineering, campfire cooking, and adventure games through STEM-based challenges designed to build confidence, problem-solving, and hands-on survival skills. They’ll test and compare natural fire-starting materials, cook over an open flame, and take on exciting shelter-building challenges that encourage teamwork and creative problem-solving. Campers will also complete a whittling project, learning to carve survival tools or nature-inspired creations. After a day of hands-on adventure, they’ll gather for a drum circle in the woods, experiencing the rhythm of nature through sound and movement.

$175.00 Quantity

Herbology Quest (Ages 8-12) Product Image

Herbology Quest (Ages 8-12)July 8-10 | 9:30 AM - 2:30 PM | Step into the wild world of plants and potions as young herbalists become nature scientists, blending math, chemistry, and hands-on experiments to Create botanical infusions, fizzing herbal potions, and wildcrafted nature recipes. Campers will forage for wild herbs, test plant properties, and mix their own herbal skincare and edible creations using STEM-based exploration. With every measurement, ratio, and experiment, they’ll unlock the science and wonder of nature’s apothecary through exciting hands-on discovery!

$175.00 Quantity

Survival Quest - SCHOLARSHIP AMOUNT *approval required

$125.00 Quantity

Total

$0.00

Credit Card

Parent (1)

First NameLast Name
Parent Information:
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Parent(2)

First NameLast Name
Address

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Phone Number (2)
Students Information:
Please tell us a little bit about your child including their interests, hobbies, how much time they typically spend outdoors, and any additional relevant information.*
Student Date of Birth*

MonthDayYear
Date
Please tell us about how your child learns best. Are there any learning difficulties we should be aware of in order to accommodate your child in their day?*
If you are applying for multiple days for your child, please list the days here:
Please describe any behavioral challenges your child may experience. What are the best ways we could help your child navigate difficult social and physical expereinces. *
DUTY TO SELF-MONITOR:
Participants, students, parents, and volunteers agree to self-monitor for signs and symptoms of COVID-19, Polio, or Monkey Pox (symptoms typically include fever, cough, and shortness of breath), and contact CNA at (616) 259 – 2247 if he/she experiences symptoms within 14 days after participating or volunteering with CNA.

CAUTIONARY ACTIVITIES
Some of the activities that children will participate in will involve close proximity to fire, sharp objects, inclement weather, wild animals, parasites such as ticks and mosquitos, poisonous plants and mushrooms,and random trail-walking people of questionable moral character. Creative Nature Academy, the property or site owner of the Activity, and all past, present and future affiliates, successors, assigns, employees,volunteers, vendors, partners, directors, teachers, agents, and officers, of such entities (collectively, the "Released Parties”) will do their best to oversee and instruct in a safe manner. Safety is the top priority of CNA, but sometimes things happen. Part of the education CNA provides is to help prepare children for difficult situations, which unfortunately may arise in the field during class time. The below release and waiver is an acknowledgment of this reality, and by signing this release, you are assuming the risk, releasing CNA, and waiving your right to sue CAN if or when a difficult situation arises.

RELEASE AND WAIVER.

I acknowledge that I derive personal satisfaction and a benefit by virtue of my participation and/or voluntarism with CNA, and I willingly engage in CNA events, classes, or other activities.

THROUGH SIGNING THIS DOCUMENT, I NOW RELEASE, WAIVE AND FOREVER
DISCHARGE ANY AND ALL LIABILITY, CLAIMS, AND DEMANDS OF WHATEVER KIND OR NATURE AGAINST THE CREATIVE NATURE ACADEMY, INCLUDING IN EACH CASE, WITHOUT LIMITATION, THEIR DIRECTOR, VOLUNTEERS, AND AGENTS (THE “RELEASED PARTIES”), EITHER IN LAW OR IN EQUITY, TO THE FULLEST EXTENT PERMISSIBLE BY LAW, INCLUDING BUT NOT LIMITED TO DAMAGES OR LOSSES CAUSED BY THE NEGLIGENCE, FAULT OR CONDUCT OF ANY KIND ON THE PART OF THE RELEASED PARTIES, INCLUDING BUT NOT LIMITED TO DEATH, BODILY INJURY, ILLNESS, ECONOMIC LOSS OR OUT OF POCKET EXPENSES, OR LOSS OR DAMAGE TO PROPERTY, WHICH I, MY HEIRS, ASSIGNEES, NEXT OF KIN AND/OR LEGALLY APPOINTED OR DESIGNATED REPRESENTATIVES, MAY HAVE OR WHICH MAY FROM THIS DATE FORWARD ACCRUE ON MY BEHALF, WHICH MAY ARISE FROM MY PARTICIPATION WITH
THE ACTIVITY.

ASSUMPTION OF THE RISK. I acknowledge and understand the following:
1. Participation includes possible exposure to and illness from infectious diseases. While particular rules, the efforts of CNA, and personal discipline may reduce this risk, the risk of serious illness and death does exist;

2. I knowingly and freely assume all such risks related to illness and infectious diseases, such as COVID-19,even if arising from the negligence or fault of the Released Parties; and

3. I hereby knowingly assume the risk of injury, harm and loss associated with the Activity, including any injury, harm and loss caused by the negligence, fault or conduct of any kind on the part of the Released Parties.

MEDICAL ACKNOWLEDGMENT AND RELEASE. I acknowledge the health risks associated with the Activity, including but not limited to transient dizziness, lightheaded, fainting, nausea, muscle cramping, musculoskeletal injury, joint pains, sprains and strains, heart attack, stroke, or sudden death. I agree that if I experience any of these or any other symptoms during the Activity, I will discontinue my participation immediately and seek appropriate medical attention. I DO HEREBY RELEASE AND FOREVER DISCHARGE THE RELEASED PARTIES FROM ANY CLAIM WHATSOEVER WHICH MAY ARISE ON ACCOUNT OF ANY FIRST AID, TREATMENT, OR SERVICE RENDERED IN CONNECTION
WITH MY PARTICIPATION IN THE ACTIVITY.

As a participant, student, parent, volunteer, or attendee, I recognize that my participation, involvement and/or attendance at any CNA class or activity is voluntary and may result in personal injury (including death) and/or property damage. By attending, observing or participating in the Activity, I acknowledge and assume all risks and dangers associated with my participation or attendance at the Activity, and I agree that the Released Parties will not be responsible for any personal injury (including death), property damage, orother loss suffered as a result of my participation in, attendance at, or observation of the Activity, regardless if any such injuries or losses are caused by the negligence of any of the Released Parties. BY SIGNING THISWAIVER AND ATTENDING AND/OR PARTICIPATING IN THE ACTIVITY, I AM GIVING A FULL RELEASE OF LIABILITY TO THE RELEASED PARTIES TO THE FULLEST EXTENT PERMITTED BY LAW.

If any portion of this Waiver is held to be invalid, I intend the other portions to remain in full force andeffect to the fullest extent permitted by law.
Parental Consent
Date of Signature*

MonthDayYear
Date
Parental Consent: Parent/Guardian Signature*

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Student Medical Information
Do you have Health Insurance coverage for your child?*

YesNo
Health Insurance Company
Health Insurance Policy Number
List all allergies and the type of reaction they cause
Does your child have any allergies?*

YesNo
Does your child have an epi-pen? If so, they must keep it with them at all times!

YesNo
Does your child have any special food restrictions?*

YesNo
Please list any special food restrictions
Does your child take any medications they will take during the program day?*

YesNo
IMPORTANT: All medications must be in the original package (daily sorters/pill keepers are not permitted.)

Please only send enough medication for the program day.
List medications and when they must be taken (example: At Breakfast, At Lunch, Before Bed, As Needed)
Has your child been diagnosed with asthma by a physician?*

YesNo
IMPORTANT: If your child has been diagnosed with asthma by a physician and has medication including tablets, nebulizers, or inhalers, they MUST bring such treatment wtih them to CNA or they will not be allowed to stay at camp!

If your child has an inhaler, they must keep it with them at ALL TIMES during the program day!
Does your child have any other significant health history (heart condition, diabetes, any injury) or does the camper have any restrictions/medical conditions that the nurse needs to be aware of?*

YesNo
If Yes, please explain
Emergency Contacts
Primary Contact: In case of emergency, please contact the following person *

First NameLast Name
Primary Contact relationship to student*
Primary Contact Home Phone Number*
Primary Contact Cell Phone Number*
Primary Contact Work Number
Secondary Contact: In case of emergency, please contact the following person *

First NameLast Name
Secondary Contact Home Phone Number*
Secondary Contact relationship to student*
Secondary Contact Cell Phone Number*
Secondary Contact Work Number
Medical Information Signature
I have read and understand the statements in this release form. I understand that should a health problem arise, I will be notified but if I cannot be reached by telephone I consent to emergency medical treatment, which may include surgery for my child as deemed necessary by competent medical personnel. I also consent to the release of information for insurance purposes.
Parent/Guardian Name*

First NameLast Name
Medical Information: Parent/Guardian Signature*

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Date of Signature*

MonthDayYear
Date
Photo and Promotional Release:*

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Date of Signature*

MonthDayYear
Date
Photo and promotional release:

I Hereby Consent to the Following for myself and my child:
To be interviewed, recorded, photographed, videotaped or filmed by representatives of Creative Nature Academy for purposes of publication, display or broadcast (print, web, digital display and all other forms of media). I agree that such interviews, recordings, articles, quotes, photographs, films, audio or video and/or any reproductions of same in any form, are the property of Creative Nature Academy, and I relinquish any present or future claim for reimbursement for said photographic or film reproduction of my likeness or for said testimonials by me.

I hereby release Creative Nature Academy, its affiliates, employees, representatives and agents from any and all claims, demands, costs and liability that may arise from the use of these interviews, recordings, photographs, videotapes or films, and/or any reproductions of same in any form, as described above, arising out of being interviewed, recorded, photographed, videotaped or filmed. I acknowledge that I have read this consent form in its entirety, or it has been read (or translated) to me, and I have had the opportunity to ask questions about it and understand it.
Student Name*

First NameLast Name
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Summer Camp Application 2025

Credit Card

Parent Information:

Students Information:

Parental Consent

Student Medical Information

Emergency Contacts

Medical Information Signature