Pacifica's Adventures in Learning (PALS) Application

Pacifica’s Adventures in Learning Day is designed for home-based learners to get outside, explore, and experience hands-on learning in nature.

Each Monday, students embark on a new adventure as they explore, learn, and connect with the world around them. The day is split into two halves: the first half is dedicated to outdoor education and fun! Students will hike through nature, identifying and cataloging plants, birds, and wildlife along the way. They'll dive into local history and culture, engage in team-building activities, and participate in sharing circles—all while developing social-emotional skills and a sense of connection to the land.

The second half of the day focuses on hands-on, project-based learning. Students will collaborate with local artisans on creative endeavors such as pottery, sewing, weaving, wool felting, and more. These activities offer opportunities for artistic expression and craftsmanship.

Throughout the day, students will be grouped by age to ensure they engage deeply with the material at their level.

The goal of this program is to provide home-based learners with a chance to immerse themselves in nature, foster healthy social-emotional growth, build lasting friendships, and gain valuable life skills and unforgettable experiences.

Optional Add-On: Before the day begins from 9am-10am, we will be hosting a Mindfulness Class. During this hour, students will explore being present in mind, body, and heart through mindfulness practices and yoga. Classes will include sit spots in nature, sensory awareness practice, and social-emotional learning.

• Ages: 5-13
• Instructor(s): Kris Dubenic, Corbin Brashear, and Vanessa Redding
• Areas of Study: Nature/Ecology, Social-Emotional Skills, Teambuilding, Art, Collaborative Play, Science, Social Science and Geography  
• Date(s):  Every Monday from September 15 through December 1, 2025.
• Session: 12-week session
• Time: 10:00 am - 3:00 pm
• Location: Pacifica: A Garden in the Siskiyous, 14615 Water Gap Rd, Williams, OR 97544
• Tuition: $35 per class equalling $420 + $80 for supplies & guest teachers fees (art projects such as clay and firing the klin etc.) for a total of $500.
• *There is also a transaction fee of 3% to use your credit card. If you want to avoid the transaction fee ($15) you can register and mail a check to: Pacifica, PO Box 1, Williams, OR 97544. Pacifica must receive your check to guarantee your child's spot. email: education@pacificagarden.org for coupon code to pay by check and not pay service fee.  
  • Sibling Discount: Each additional child in one family gets $50 off tuition.

DISCLAIMER: Due to the nature of our programs, which may involve various physical activities and an increased level of risk, we may face challenges in supporting students. While we are committed to providing a safe and enriching experience for all students, the level of supervision and individualized support required for children with specific behavioral or emotional needs may exceed our current staffing capacity. We encourage families to email us at education@pacificagarden.org to discuss their child’s needs with us in advance so we can assess whether our program is a suitable fit.

Please note that we reserve the right to unenroll a student if their behavioral challenges or supervision needs disrupt the class or exceed what our staff can reasonably provide. In such cases, parents or guardians will be required to withdraw their child from the program.

The parent or guardian completing this form will automatically be the first emergency contact. If you are not available, please list two additional contacts that we can call in case of an emergency. 

Please notify this emergency contact of your child/dependent's PALS dates and that they are listed as an additional emergency contact.

Please provide any health information needed to maintain the health and safety of your child during their time at Pacifica. Health information shared will remain confidential. Especially note any health, emotional, or physical problems.

For the relief of minor health problems that might temporarily affect your child’s comfort while at Pacifica, there is a small supply of common over-the-counter medications at the site. Do not send these medications with your student.

THE HEALTH HISTORY FORM IS CHECKED FOR ALLERGIES BEFORE ANY MEDICATION IS GIVEN.

Medications available at Pacifica are:

• Alcohol Wipes Aloe Vera gel – burns/sunburns
• Antibiotic Cream/Ointment
• Anti-diarrheal (Loperamide)
• Antihistamines (Benadryl, Chlor-Trimeton, Loratadine)
• Calcium Carbonate for indigestion (Tums)
• Cream for athlete’s foot or ringworm (Lotrimin or Tinactin)
• Cream for Chapped Skin Cream for itching (Hydrocortisone, Benadryl, Calamine lotion)
• Cough Drops Glucose for diabetic emergency
• Eye Drops
• Insect repellent Lotion
• Milk of Magnesia Non-aspirin pain/fever relievers (Tylenol and Advil)
• Soap for poison oak (Tecnu)
• Sunscreen

NOTE: Brand names have been listed but their generic equivalent or the same medication of a different brand may be substituted. We do not stock chewable or liquid pain relievers.

Select whether or not you would like your child to be able to receive over-the-counter (OTC) medication if needed. If this list contains medication you do not want your child to receive, please select the third option "some" and then explain your reasons below.

DISCLAIMER & PARTICIPATION AGREEMENT

By enrolling your child in our programs, you acknowledge and agree to the following terms:

Our programs may involve physical activities and an increased level of risk. While we strive to create a safe and enriching environment for all students, our staffing and resources may not allow for the level of supervision and individualized support required by some children with specific behavioral or emotional needs.

We encourage all families to contact us in advance at education@pacificagarden.org to discuss their child’s needs so we can determine whether our program is an appropriate fit.

By proceeding with enrollment, you understand and agree that:

• If your child’s behavior is consistently disruptive to the class, or
• If their need for supervision exceeds what our staff can reasonably provide,

We reserve the right to cancel their enrollment, and you will be required to withdraw your child from the program.

These measures are in place to ensure a safe and supportive experience for all students.

Photographs and videos will be taken of kids and activities. This media may be used in advertisements or social media posts to showcase the fun activities that Pacifica has to offer! Please read and fill out the media release below.

Personally identifiable information, including a student’s photograph, participation in program activities, video appearances, and receipt of awards, may be occasionally used or released to promote Pacifica programs. Use or release may include a child’s name, picture, and/or video appearing in Pacifica promotional materials prepared for the purpose of informing the community about the Pacifica events. Pacifica materials may discuss some aspect of our programs or may request the donation of tools, games or other materials from community citizens. Use or release also includes our website, news stories in print, social media or television media.

Use or release will NOT include a child's name without additional permission granted by the parent.

ACCEPTANCE of RISK and RESPONSIBILITY

I am aware that this event or activity may entail risk of injury to myself or my dependent, to spectators and to third parties.  I expressly agree, covenant and promise to accept and assume all responsibility and risk or any damage to myself, my dependents, or my property arising from our participation in activities at Pacifica.  I decide to participate in and/or allow my child/dependent to participate in these activities in spite of the stated risks.

RELEASE and DISCHARGE of LIABILITY

I, the undersigned, hereby acknowledge that I have read the assumption of risk statement and fully understand there may be certain elements of risk inherent in outdoor or indoor activities which are beyond the control of the instructors, staff, agents, officers, and employees of Pacifica. 

In consideration of Pacifica furnishing services to enable myself or my dependent to participate, I hereby assume all risk to myself or my dependent or damage to property arising out of participation in this activity, including hazards associated with any defect in a manufacturer’s product.  I hereby specifically and voluntarily release Pacifica from any and all liability, including negligence (active or passive), demands or actions as to any right of action or claim to relief which may accrue to me as a result of participation in outdoor and indoor activities.

I further agree, promise and covenant to hold harmless and indemnify Pacifica from all litigation costs, including attorney fees, or from any costs incurred in connection with claims for bodily injury or property damage which I may negligently or intentionally cause to spectators or third parties in the course of my participation.

I further understand Pacifica carries no medical insurance for the protection of participants in outdoor recreation activities and any insurance coverage existing with respect to Pacifica shall not alter the terms of this waiver nor impose any liability on Pacifica.

ACKNOWLEDGEMENT of EFFECT of RELEASE

I understand and acknowledge that by signing this release I have agreed not to assert legal claims, which I might otherwise possibly assert to maintain against Pacifica, based on my or my dependent’s participation in an activity. I also understand and acknowledge that by signing this release I assume full responsibility and legal liability for the claims or other legal demands, including litigation costs, which may be asserted by spectators or other third parties against me as a result of my or my dependent’s participation.

I HAVE CAREFULLY READ THIS AGREEMENT AND FULLY UNDERSTAND ITS CONTENTS.  

I AM AWARE THIS A RELEASE OF LIABILITY AND I SIGN IT OF MY OWN FREE WILL.

Payment and Refund Policy:

Full payment at time of registration is required. Up until two weeks prior to the start of the event, you will receive a full refund (minus a $10 service charge) should you need to cancel your registration. However, cancellations made after this two-week time frame are nonrefundable​. Should Pacifica cancel the event, all participants will receive a full refund or credit toward future classes.