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NAWS / Coyote Trails School of Nature
Program Application
 
Participant information (one form per applicant)
 
I am applying for:
 
Weekend Programs November - May
  Earth-Art!! Day Camp
 July 26 - 30
Fox Trail Adventure Class - All Ages July 4 - 10
Bear Skills- All Ages July 11 - 17
Little Fox Class (7 and under) Day Camp
 July 5 - 9
Fox Naturalist - All Ages July 25 - 31
Sink & Fade - (13-adult) August 1 - 7
Wilderness Vision Quest (postponed)
 Sept. 4 - 11
     
*Last Name: *First Name:
 
How did you learn about Coyote Trails?
Have you been to Coyote Trails before? Yes No
If yes, what class(es) and dates?
   
*Mailing Address:
*City: *State: *Zip:
Country: *Email:
 
Phone Number(s):
 
*Date of Birth: *Gender Male Female
 
 
Emergency Contact Information  
Primary Emergency Information  
   
*Name:  
Address: City: State: Zip:
*Day Phone: Evening Phone:
Emergency Contact Information  
Secondary Emergency Information  
   
Name:  
Address: City: State: Zip:
Day Phone: Evening Phone:
 
Travel Information
I / We plan to arrive at Coyote Trails by:
Car
Airplane ( Airport information will be included in your follow-up packet )
 
YOUR TRAVEL INFORMATION MAY CHANGE AS YOUR PLANS SOLIDIFY. PLEASE CALL WITH ANY QUESTIONS and PLEASE SEND YOUR FLIGHT ITINERARY UPON BOOKING.
   
 
Preliminary Health and Diet Information
   
Dietary needs and /or allergy concerns:
If none, please write "none".
   
List any allergies to medication:
   
Do you have SERIOUS food allergies that cause medical complications? If yes, please list them, and rate the severity on a scale of 1 – 10.
(Please note that we are not always able to accommodate mild food allergies/sensitivities. We are concerned with foods that can NOT, under any circumstances, be eaten without serious side effects.)
   
Any medical conditions, information and medications(s) we need to be aware of:
   
Primary physician and phone number:
   
 
Payment Requirements
 
If paying with a credit card, please read the release form and check the box then proceed to submit button. For all other methods of payment, print your completed online application and send it to CTSN with your signature.  Each student must submit a signed application and liability waiver prior to class
 
 Cancellation Policy
 
I acknowledge that should I fail to notify Coyote Trails of my cancellation by 12:00 noon PST two days prior to the first day of class, I am responsible for my full tuition. If I cancel my registration prior to the deadline $100.00 of the $300.00  NON-REFUNDABLE deposit is transferable to another class within the same calendar year.
 
Note: If participant is under 18 years of age a parental or guardian signature is required. Please print and sign the "Permission and Release" form and return it to Coyote Trails. 
 
 
I have read and understand the permission and release form. By checking this box I accept the terms and agree to participate and/or have my child participate in any NAWS/Coyote Trails program. This checked box represents my authorizing signature. Click here to view the Permission and Release form.
 
    - and return to check out