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2021 DWP Cares Youth Application

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2021 DWP Cares Youth Application Program contacts: Kramer Wimberley / Riane Tyler Email: [email protected] TEL: +1 (732) 887 - 0903 / +1 (754) 971 - 9795 DIVINGWITHAPURPOSE Collective Approach to Restoring our Eco Systems (CARES) “Restoring Our Oceans, Preserving Our Heritage” Virtual Module: General Program Curriculum In-Situ Module The first annual Diving With a Purpose (DWP)Collective Approach to Restoring our Ecosystems (CARES) program, is comprised of two Modules: Virtual Module In-Situ Module, (40+ Contact HRS): Key 01/16/2021 - 01:00PM EST - 4:00PM EST Largo DWP - July 11th - 18th, 2021 02/20/2021 - 01:00PM EST - 4:00PM EST 03/20/2021 - 01:00PM EST - 4:00PM EST 04/17/2021 - 01:00PM EST - 4:00PM EST 05/15/2021 - 01:00PM EST - 4:00PM EST In the past, DWP began a waiting list within two weeks after each annual announcement. Please do not wait to register, slots are limited. This can be a very rewarding experience for those of you who sign up, but before you do please read the attached summary of the program Reef Monitoring Project for an idea of what to expect. Upon completion of the course, you will have achieved the basic requirements for the following certifications: PADI Project AWARE Coral Reef Conservation Specialty Reef Check EcoDiver *Upon successful completion of the DWP-CARES performance requirements, you are eligible to receive aforementioned certifications. Program contacts: Kramer Wimberley / Riane Tyler Email: [email protected] TEL: +1 (732) 887 - 0903 / +1 (754) 971 - 9795 WHAT TO LOOK FORWARD TO: • Learning the techniques for facilitating reef • A SCUBA setting monitoring surveys, establishing and • Learn investigative &research maintaining a coral nursery techniques • Learning the techniques for coral nursery • Team discovery & analyses maintenance and out-planting with CRF • Site mapping and rugosity indexing • 40+ Contact hours for the duration of the • Roving Survey data collection course. Dive sites 15-40ft.deep Module 1: Virtual Classroom (5 sessions) • • Research methods include, but are not • Module 2: Classroom and in-water field limited to, skills and techniques employed in research coral reef monitoring • Learning about the environmental effects of climate change and its impact on the coral eco-system ELIGIBILITY & WHAT YOU NEED Appropriate thermal wear for 70º+ H O • Experience: 30 logged dives minimally • 2 in which ten (10) must be ocean • Good verbal and written communication dives. Also, you must have logged at least skills six (6) dives in the last year. • Ability to identify key reef species by the end of virtual module & record accurate data • Must be 15 years of age on land & underwater Peak Buoyancy Skills (verification • • Proficient with the Imperial and Metric required if under 50 dives) measurement system and how to convert from • Dive accident insurance (i.e. DAN) one to the other • Your own dive gear or ability to rent • Basic computer & Data entry skills (less tank & weights) • Confidence with long term bottom time • Thirst for new underwater experiences dives (60-90min.) EXPENSES: • 50% Deposit due with registration • Total Fee $700.00 • If Paying with PayPal add 3.5% • Pay Pal: paypal.me/mlampkin0315 • Certification Registration (3 specialties) $150.00 EXPENSES/COSTS: CHECK ALL THAT APPLY Item Cost (By check) Cost (By PayPal) CORAL REFF CONSERVATIONIST 50.00 51.75 PROJECT AWARE SPECIALIST 50.00 51.75 REEF CHECK ECO DIVER 50.00 51.75 TOTAL Registration can be made through PayPal, https://www.paypal.com/us/home. A 3.5% service charge applies. The PayPal email is the DWP treasurer [email protected]. In the note section, indicate DWP XVI and the registration type. When registering on-line, you are still required to fill out an application and provide the supporting information below via mail or email to [email protected]. Payments must be submitted with your application along with a copy of your C-card and proof of dive insurance. Without these enclosures, we are unable to process your request to participate in DWP XVI. ALL registration forms with enclosures (check or money order, C-Card and proof of dive insurance) should be mailed to: DWP * c/o Ken Stewart * 1309 Jackson St. * Nashville, TN 37208 -3000. Checks or Money Orders should be issued to DWP. ALL questions pertaining to DWP C.A.R.E.S should also be directed to: Kramer Wimberley / Riane Tyler Email: [email protected] TEL: +1 (732) 887 - 0903 / +1 (754) 971 - 9795 Liability Waiver and Release: I, release Diving With a Purpose (DWP), its officers, trip leaders, committee members, or other members of the organization from any and all liabilities, claims, losses, expenses, injuries, or damages to persons or property which may arise out of, or be connected in any way with, any scheduled or unscheduled dive trip or activity it may offer. In exchange for being permitted to participate in any activity, I will not institute any action at law or in equity in consideration of any injury or other loss or damage sustained, or that may be sustained, by me as a consequence of my participation in an activity sponsored in full or in part by DWP. My participation in any activity offered by DWP is strictly voluntary. I understand that DWP and no other member of the organization shall in any way be responsible for the safety of any member or be responsible for the services of accommodations being offered by other enterprises or persons on all trips and/or activities, scheduled or unscheduled by this organization. I agree to abide by the by-laws, rules and regulations of DWP. I will abide by safe diving practices and conduct my behavior in a responsible manner. I acknowledge that I have read, understood and will adhere to DWP’s harassment policy. The DWP harassment policy can be viewed and downloaded at www.divingwithapurpose.org. This Waiver and Release form will be binding on me and on behalf of my heirs, agents, assigns and legal representatives. I further state that I have carefully read the foregoing Waiver and Release in its entirety. I sign this Waiver and Release knowingly and voluntarily with a full understanding of its content. Signature: Parent/Legal Guardian: Date: Programcontacts: Kramer Wimberley / Riane Tyler Email: [email protected] TEL: +1 (732) 887 - 0903 / +1 (754) 971 - 9795 DWP CARES Program includes daily academics covering underwater reef monitoring skills, lessons & activities; Land and underwater supplies for various surveyor tasks and results; five days of structured diving plus tanks & weights. REGISTRATION DEADLINE IS JANUARY 10, 2021!! Registration consists of completing the application and returning it with the course fee. This will be based on a first come, first served basis. The DWP-CARES fee is due in full with the completed DWP-CARES registration form and a copy of your SCUBA certification card. No refunds after JANUARY 16th, 2021 due to pre-program planning cost obligations. If you cannot participate after registration payment, replacements are acceptable if DWP is notified by April 30, 2021. ACCOMODATIONS Youth will be staying at the Travelodge by Wyndham Florida City/Homestead/Everglades 409 SE 1st Ave, Florida City, FL 33034•(305) 482-1961 Program contacts: Kramer Wimberley / Riane Tyler Email: [email protected] TEL: +1 (732) 887 - 0903 / +1 (754) 971 - 9795 Registration Form: First Name: Last Name: Date: Address: City: State: Zip: Parent/Guardians Name: Student Phone: Parent/Guardians Phone: Student Email: Parent/Guardians Email: Date of Birth: Age: Gender Shirt Size: Diving Information Dive Certification and Level Organization: Dive Insurer: and Number Number of Logged Dives: Deepest Dive: Date of Last Dive: Home SCUBA Club: NABS Member: Member # Registration Forms to: Ken Stewart: 1309 Jackson St. Nashville, TN 37208-3000 2 (615)730-4906 Ken Stewart (732)887-0903 Kramer Wimberley If you pay by PayPal add: 3.5% Pay Pal: paypal.me/mlampkin0315 EMERGENCY CONTACT INFORMATION Health Insurance Carrier: Account# Primary Physicians Name: Contact Phone# 1st Contact: Name/Relationship: Phone# Address: City: State: Zip 2nd Contact: Name/Relationship: Phone# Address: City: State: Zip: Medical or Special Needs List any medical conditions or special needs (handicapping conditions, dietary restraints, etc.) you may have: Program contacts: Kramer Wimberley / Riane Tyler Email: [email protected] TEL: +1 (732) 887 - 0903 / +1 (754) 971 - 9795 Liability Waiver and Release: I___________________________, here by release Diving With a Purpose(DWP),its officers, trip leaders, instructors, committee members, or other members of the organization from any and all liabilities, claims, losses, expenses, injuries, or damages to persons or property which may arise out of, or be connected in any way with, any scheduled or unscheduled dive trip or activity it may offer. In exchange for being permitted to participate in any activity, I will not institute any action at law or in equity in consideration of any injury or other loss or damage sustained, or that may be sustained, by me as a consequence of my participation in an activity sponsored in full or in part by DWP. My participation in any activity offered by DWP is strictly voluntary. I understand that DWP and no other member of the organization shall in any way be responsible for the safety of any member or be responsible for the services of accommodations being offered by other enterprises or personal trips and/or activities, scheduled or unscheduled by this organization. I agree to abide by the by-laws, rules, and regulations of DWP. I will abide by safe diving practices and conduct my behavior un a responsible manner. I acknowledge that I have read, understood, and will adhere to DWP’s harassment policy. The DWP harassment policy can be viewed and downloaded at www.divingwithapurpose.org. This Liability Waiver and Release form will be binding in me and on behalf of my heirs, agents, assigns and legal representatives.
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