Camp Kellogg Registration Summer 2023 Camp Kellogg Registration Summer 2023 Step 1 of 4 25% Child's Name* Child's Age*Guardian Name(s)* Phone Number*Best Contact Email* Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code SessionsSession 1 (June 5 - 9)Friends of the Forest exemplifying RESPECT & RELEVANCE Spruce Campers: Ages 5-6 Forest Guests are Best: A week exploring habitats, ecology, mushrooms, fungi, birds, and animals. Garden care and plant observation will round out the dirty fun! | 9 a.m. - 2 p.m. | $210 | 6 spots (0 spots remaining) Birch Campers: Ages 6-8 The Nature of Art- Using a variety of mediums, campers will be guided to create art utilizing natural and recycled materials for a full sensory art experience, nurturing their connection to nature. | M-Th 9 a.m. – 4 p.m. / F 9 a.m. – 2 p.m. | $285 | 9 spots (0 spots remaining) Hemlock Campers: Ages 6-8 Edible Education- Soil Science Secrets: What’s in the soil and how does it help our plants grow? Campers will explore the scientific and practical components of farming in a week of seed, soil, plant and pollinator exploration. | M-Th 9 a.m. - 4 p.m. / F 9 a.m. - 2 p.m. | $285 | 10 spots (0 spots remaining) Cottonwood Campers: Ages 9-13 Bushcraft & Wilderness Skills: Crafting and wilderness skills for outdoor adventures all while practicing survival safety. | M-Th 9 a.m. - 4 p.m. / F 9 a.m. - 2 p.m. | $285 | 10 spots (0 spots remaining) Aspen LIT: Ages 14-17 | M-Th 8:45 a.m. - 4 p.m. / F 9 a.m. - 2 p.m. | $150 | 8 spots (5 spots remaining) Session 2 (June 12 - 16)National Park Protectors demonstrating RESPONSIBILITY Denali Campers: Ages 5-6 Micro Water Wildness – Water activity meets the world of the unseen through investigations under the microscope. | 9 a.m. - 2 p.m. | $210 | 8 spots (0 spots remaining) Kenai Campers: Ages 6-8 Bushcraft & Wilderness Skills: Crafting and wilderness skills for outdoor adventures all while practicing survival safety. | M-Th 9 a.m. - 4 p.m. / F 9 a.m. - 2 p.m. | $285 | 10 spots (0 spots remaining) Aleutian Campers: Ages 9-13 Recycled Runway: An endeavor in sustainable fashion, campers will use recycled and repurposed materials to create a wearable art piece! Campers will dabble in natural dyeing, sustainable fabrics, and natural fibers. The culmination of their learning and creativity will be showcased in a runway fashion show! | M-Th 9 a.m. - 4 p.m. / F 9 a.m. - 2 p.m. | $285 | 11 spots (0 spots remaining) Chugach Campers: Ages 9-13 Edible Education-Cooking with Curiosity: A farm-to-table experience; campers will learn the chemistry and techniques of the kitchen as they utilize their fresh harvests from their time digging on Spring Creek Farm to prepare and sample an array of delicious fresh foods. | M-Th 9 a.m. - 4 p.m. / F 9 a.m. - 2 p.m. | $285 | 9 spots (0 spots remaining) Katmai LIT: Ages 14-17 | M-Th 8:45 a.m. - 4 p.m. / F 9 a.m. - 2 p.m. | $150 | 8 spots (6 spots remaining) Session 3 (June 19 - 23)The Ebb and Flow of Rivers cultivating RECIPROCITY Yukon Campers: Ages 5-6 Wilderness Wellness – The joy of learning new skills for relating safely with the magnificence of the outdoors and our friends. | 9 a.m. - 2 p.m. | $210 | 8 spots (0 spots remaining) Knik Campers: Ages 6-8 Edible Education-Cooking with Curiosity: A farm-to-table experience; campers will learn the chemistry and techniques of the kitchen as they utilize their fresh harvests from their time digging on Spring Creek Farm to prepare and sample an array of delicious fresh foods. | M-Th 9 a.m. – 4 p.m. / F 9 a.m. – 2 p.m. | $285 | 8 spots (0 spots remaining) Susitna Campers: Ages 7-9 Mysterious Wonders of Nature: Fascinating experiments in physics and chemistry will surely ignite the curiosity in young scientists during this week’s camp of natural sciences! | M-Th 9 a.m. - 4 p.m. / F 9 a.m. - 2 p.m. | $285 | 10 spots (0 spots remaining) Copper Campers: Ages 9-13 Adventure Laboratory: Grab your goggles and lab coat for this week of camp! Discover the hows and whys behind some wacky, adventurous, and extreme STEM experiments. | M-Th 9 a.m. - 4 p.m. / F 9 a.m. - 2 p.m. | $285 | 12 spots (0 spots remaining) Gulkana LIT:Ages 14-17 | M-Th 8:45 a.m. - 4 p.m. / F 9 a.m. - 2 p.m. | $150 | 8 spots (7 spots remaining) Session 4 (June 26 - June 30)The Majesty of Mountains embodying WISDOM Denali Campers: Ages 5-6 Crafty Creations – Develop dexterity in fingers and thinking through a variety of creative crafts including building, sculpting, and whittling. | 9 a.m. - 2 p.m. | $210 | 8 spots (0 spots remaining) Kenai Campers: Ages 6-8 Fairy Gardens & Gnome Homes: A week of creativity and fantasy play infused with soil science, gardening, storytelling, and nature crafts. | M-Th 9 a.m. - 4 p.m. / F 9 a.m. - 2 p.m. | $285 | 10 spots (0 spots remaining) Knik Campers: Ages 8-13 The Spring Creek Farm Experience: Pull on your garden gloves and jump into a week side by side with the Spring Creek Farm crew, harvesting and tasting Alaskan grown vegetables on their journey from seed to farm stand. | M-Th 9 a.m. - 4 p.m. / F 9 a.m. - 2 p.m. | $285 | 10 spots (0 spots remaining) Wrangell Campers: Ages 9-13 Battle of the Big 5: A week of challenges of body, mind, and creativity: orienteering, wayfinding, puzzles, obstacle courses, and so many games! | M-Th 9 a.m. - 4 p.m. / F 9 a.m. - 2 p.m. | $285 | 12 spots (0 spots remaining) Katmai LIT: Ages 14-17 | M-Th 8:45 a.m. - 4 p.m. / F 9 a.m. - 2 p.m. | $150 | 8 spots (4 spots remaining) Total $0.00 Camper T-shirt Size (included with camp cost)* Youth XS Youth S Youth M Youth L XS S M L XL Additional Friends & Family T-shirts ($20 each)Youth XS Quantity Price: $20.00 Quantity Youth S Quantity Price: $20.00 Quantity Youth M Quantity Price: $20.00 Quantity Youth L Quantity Price: $20.00 Quantity XS Quantity Price: $20.00 Quantity S Quantity Price: $20.00 Quantity M Quantity Price: $20.00 Quantity L Quantity Price: $20.00 Quantity XL Quantity Price: $20.00 Quantity XXL Quantity Price: $20.00 Quantity Total $0.00 Cancellation and Refund Policy*• There is a non-refundable $50 deposit, per camper, per week of registered camp. The deposit is applied to the camp cost. • If you cancel two or more weeks prior to camp, you will receive a 100% refund (less the non-refundable $50 deposit) • If you cancel within two weeks of the camp start date, you are responsible for 50% of the total camp cost if we are unable to fill the spot. • If you withdraw from camp after the start date, there is no refund. • The camp cost must be paid in full two weeks prior to the start date. I understand and agree. Emergency Contact Name* Emergency Contact Relationship* Emergency Contact Phone Number(s)* Does your student have allergies to any of the following?*Select all that apply Insect Bites/Stings Foods Environmental Medicines No Known Allergies Other (specify below) If you indicated yes to any of the above, please provide detail about the allergy, its severity, and its management.*Does your student have a history of any of the following conditions?*Select all that apply Heart Defect/Disease Diabetes Hypertension Epilepsy Bleeding/Clotting Disorders Asthma Mental/Emotional Illness Skin Conditions No Known Medical Conditions Other (specify below) If you indicated yes to any of the above medical conditions, please provide greater detail about the condition, its severity, and its management.*Is your student currently taking any prescription medications? If yes, please provide relevant information.* Is there any important health information that we missed? Photo Release*I grant Alaska Pacific University and its representatives and employees the right to take photographs of my child and his/her property in connection with Camp Kellogg programming. I authorize Camp Kellogg, its assigns and transferees to copyright, use and publish the photographs in print and/or electronically. I agree that Camp Kellogg may use such photographs of my child with or without his/her name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and/or web content. I agree I do not agree Consent for Emergency Medical or Surgical Care*In the rare event of an emergency, I hereby give my permission to the medical personnel selected by the program director to provide routine health care; to administer medications; to order x-rays, routine tests, treatment; to release any record necessary to insurance purposes; and to provide or arrange necessary related transportation for me/my child. In the event that I cannot be reached in an emergency, I hereby give permission to the physician selected by the program director to secure and administer treatment, including hospitalization, for the person named above. This form may be photocopied for trips away from campus. All information is strictly confidential. Camp Kellogg does not cover accident insurance coverage for participants; you must carry your own accident insurance coverage. I authorize the above information for insurance purposes. It is understood that a conscientious effort will be made to locate me or my child's other legal guardian. I understand my obligation to keep Camp Kellogg informed of my whereabouts. I will assume the cost of necessary medical or surgical care. I agree I do not agree Authorization to Participate*My son/daughter/dependent has permission to participate in all Camp Kellogg activities. I recognize that my child will be participating in active, outdoor programs with other children and that accidental injuries and illnesses may result. I assume the inherent risks of, but not limited to, the following: running, hiking, skiing, snow shoeing, ice skating, dog mushing, group games, wildlife, and inclement weather, and authorize my child's participation. Camp Kellogg instructors do not provide transportation to participants. I understand that I am responsible for transporting my child to any activity occurring off-site. If I am unable to attend, it is my responsibility to arrange a ride-share with another parent or guardian. Camp Kellogg is hereby released from all claims, liability, and losses for actions taken in good faith during this program. I agree I HAVE READ ALL QUESTIONS INCLUDED IN THIS FORM THOROUGHLY, AGREE TO ITS TERMS AND I CERTIFY THAT THE ABOVE INFORMATION IS TRUE AND ACCURATE AND COMPLETED TO THE BEST OF MY KNOWLEDGE.*If you agree to the above statement, please type your name in the box below. Total $0.00 Credit Card* American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Month010203040506070809101112 Year20232024202520262027202820292030203120322033203420352036203720382039204020412042 Expiration Date Security Code Cardholder Name Δ
