Tracks & Trail Cameras Science Registration Tracks & Trail Cameras: A Family Adventure Workshop Series Registration Form Fields marked with an * are required Caregiver First and Last Name Caregiver’s Name (This should be the name of the person who will be attending the workshops with the child.) * Caregiver Gender: * Child Name: * Child Gender * Child’s date of birth (mm/dd/yyyy): * How many adults in your family are interested in participating? (Reminder that the same adult needs to attend all 6 workshops): * How many additional children between the ages of 8 and 11 years are interested in participating? (Additional children welcomed only if space permits). Provide additional child(ren)’s age and gender: * How many children age 12 and older would be interested in participating? (Reminder that older children are welcome only if space permits). * Ethnicity How would you describe your ethnic identity? (Check all that apply.) White Native American or American Indian Hispanic or Latino/a/x Asian / Pacific Islander Black or African American Prefer not to answer Other: What is your occupation/vocation/job? * Home Address: * State: * Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming ARMED FORCES AFRICA \ CANADA \ EUROPE \ MIDDLE EAST ARMED FORCES AMERICA (EXCEPT CANADA) ARMED FORCES PACIFIC Home Phone: E-mail: * City: * ZIP code: * Cell Phone: What is the best way to contact you? * Home phone Cell phone call Cell phone text E-mail What day and time is best to contact you? * Caregiver questions Caregivers, please answer these questions. What are some of the hobbies and activities you do as a family? * Why are you interested in participating in this workshop series? * We strive to ensure that the program is accessible as possible. Please let us know if there is anything we should be aware of to help ensure you and your child have the best experience possible. * Any additional information to share about yourself or your family? * Questions for child Please have your child respond in their own words to the following questions. What are some of the hobbies and activities you do as a family? * Why are you interested in participating in this workshop series? * Any additional information you’d like to share about yourself or your family? * By checking the box, I am committing to the following if accepted into the program: * Commitments Attend 6 workshops at the High Desert Museum and another field locations within Central Oregon.Participate in fun, outdoor, hands-on activities.Create and share stories based on your experiences.Provide feedback about the workshops through surveys and virtual interviews.The benefits that I will receive from my full participation in the program include:An opportunity to engage in a series of fun and educational activities as a family.Increased understanding of the natural world of Central Oregon, including the predators and prey that live here.An opportunity to work with wildlife professionals and Museum educators across Central Oregon.Contributing your family’s knowledge and observations to help increase scientists’ understanding of animals in the region.Creating and sharing the story of your family’s experience in the program.Receiving a $150 stipend, gas cards for travel and working lunches. Confirmation Thank you for your interest in Tracks & Trail Cameras: A Family Adventure Workshop Series. If you are a human seeing this field, please leave it empty.
