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Northern Forest Explorers 2016 REGISTRATION FORM

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Northern Forest Explorers 2016 REGISTRATION FORM Northern Forest Explorers 2016 REGISTRATION FORM Please complete all pages of this application as needed – thanks! Participant Name: Parent/Guardian Name: (circle one) _____________________________________________ _____________________________________________ Birthdate: ___/___/___ Age: _______________ Address: Gender (circle one): M F _____________________________________________ Current School: ________________________________ _____________________________________________ Please have participant provide a brief paragraph about Email: ________________________________________ why they want to attend this trip. Thanks! Cell: _________________ Phone: __________________ Have you participated in a trip before? Please indicate location and number of trips. See 2016 Trip Descriptions attached for more detail. Please check one: _____________________________________________ New York Trip Fee: $500 Adirondack Lakes ..................................... July 11–15 Fee includes all meals, equipment, guides and Heart of the Adirondacks (Raquette) ........ July 25–29 instruction (see attachment for scholarship availability). Full refund minus a $75 administrative fee is available up to 30 days before the trip starts. A 50% refund will be given within 30 days of the trip. Vermont Northeast Kingdom Wild (Clyde River) ..... July 5–8 Check for $500 enclosed (make out to “Northern Forest Canoe Trail”) Wild & Scenic Missisquoi .......................... Aug 1–5 Charge my credit card $500 New Hampshire Card # _________________________________ Exp _________ Androscoggin Whitewater ......................... June 27–July 1 Name on card: _________________________________________ Wildlife to Whitewater (Lake Umbagog)….. July 11–15 The Mighty Connecticut ............................. July 18–22 Circle one: VISA MASTERCARD AMERICAN EXPRESS DISCOVER Billing address if different than above: Maine _____________________________________________________ Moose River Bow Loop .............................. July 5-8 Western Maine’s Mountains (Flagstaff) .... July 18–22 _____________________________________________________ Thoreau’s Maine (Penobscot )* ................ Aug 1–5 Email, fax or mail completed forms with payment Maine’s Wild Allagash* ............................. Aug 8–12 or scholarship form to program contact: Richardson Lake Explorers ….. ................... Aug 8–12 MARTHE PETERSON Northern Forest Canoe Trail *These trips are open to Maine residents only. PO Box 565 Waitsfield, VT 05673 Email: [email protected] ~ Fax: (802) 329-2239 ~ Phone: (802) 496-2285 x5 Northern Forest Explorers 2016 Registration Form 2016 Trip Descriptions All trips are 5 days Monday–Friday and for ages 10–14 unless otherwise noted. June 27–July 1 Androscoggin Whitewater (NH) From the wildlife rich waters of Lake Umbagog National Wildlife Refuge to the churning whitewater of the Upper Androscoggin River between Errol and Milan, NH, this trip includes both flatwater canoeing and whitewater kayaking while camping at remote wilderness campsites. Trip Guide: Great Glen Outfitters July 5*– 8 (*July 5 is a Tuesday) Northeast Kingdom Wild (VT) From its headwaters in Island Pond to its terminus in Lake Memphremagog, the Clyde River is made up of distinctive wetlands, flat and quick waters, and a history of legendary salmon runs and Native trade routes. Trip Guide: Northwoods Stewardship Center July 5*– 8 (*July 5 is a Tuesday) Moose River Bow Loop Trip (ME) Start your adventure on Holeb and Attean Ponds then paddle back to where you started on a secluded bow section of the Moose River. Expect to see plenty of moose, beavers, geese, and loons. The 34 mile Moose River Bow Trip is one of the most outstanding canoe trips in Maine. Trip Guide: Adventure Bound July 11–15 Wildlife to Whitewater (NH) From an aerial adventure ropes course to the wildlife rich waters of Lake Umbagog, this trip offers both exquisite vistas and high adventure. After paddling through the Umbagog National Wildlife Refuge and learning about wildlife and wilderness skills, the trip concludes with a day of whitewater rafting (Class II - IV depending on group’s technical ability). Trip Guide: ELC Outdoors July 11–15 Adirondack Lakes (NY) Join us for incredible paddling in New York's Adirondack Mountains. The trip begins on Blue Mountain Lake, and then heads to Raquette Lake and Forked Lake. Incredible scenery and history. Some fine hikes to some killer views are also part of this adventure. Trip guide: Raquette River Outfitters. July 18–22 The Mighty Connecticut (NH) From the Class I rapids and quickwater of the northern reaches to wide meandering stretches, this section of the CT River, from Colebrook to Guildhall teems with soaring birds of prey, expansive views and prime riverside camping. Trip Guide: Northwoods Stewardship Center July 18–22 Western Maine’s Mountains Flagstaff Lake will be your base for this popular paddling trip in Maine’s High Peaks Region. Trip guide: Adventure Bound. July 25–29 Heart of the Adirondacks (NY) Paddle up Long Lake and down the Raquette River in New York. Explore beautiful Raquette Falls and the silver maple and white pine forests that make this section such a favorite for paddlers. Trip guide: Raquette River Outfitters. August 1–5 Wild & Scenic Missisquoi (VT) Join us for a 5-day trip down the newly designated Wild & Scenic upper Missisquoi River and experience first-hand what makes this river special. Trip guide: Montgomery Adventures August 1–5 Thoreau's Maine (This trip is open to Maine residents only) The West Branch of the Penobscot is the location for an incredible 5-day paddle in a land that Henry David Thoreau memorialized in his novel The Maine Woods - an adventure for all! Trip guide: Maine Winter Sports Center. Northern Forest Explorers 2016 Registration Form August 8–12 Richardson Lake Explorers (ME) From an aerial adventure ropes course to the wildlife rich waters of Richardson Lake, this trip offers both exquisite vistas and high adventure. After paddling across Richardson Lake and learning about wildlife and wilderness skills, the trip concludes with a day of whitewater rafting (Class II - IV depending on group’s technical ability). Trip Guide: ELC Outdoors August 8–12 Maine's Wild Allagash (This trip is open to Maine residents only) An incredible trip in one of the wildest areas in the eastern US on the Allagash Wilderness Waterway. Umsaskis Lake to Twin Brook. Trip guide: Maine Winter Sports Center. RELEASE FOR USE OF PHOTOS ALL APPLICANTS ARE REQUIRED TO FILL OUT AND SIGN Northern Forest Explorers is an initiative of the Northern Forest Canoe Trail (NFCT). NFCT uses images of its programs and participants in a variety of reports, publications documents and other promotional materials. These images represent NFCT as a whole and are essential in documenting and promoting our programs and accomplishments. I hereby grant the Northern Forest Canoe Trail permission to use, reproduce or distribute any photographs or video of my child(ren) taken during the program for use in materials it or its partners may create. Parent/Guardian Signature: ___________________________________ Date: _________________ For parents and guardians: By listing your children’s name below you give the NFCT permission to use, reproduce, or distribute any photographs or video taken during the program for use in materials we may create. Participant name ___________________________________________________ Participant name ___________________________________________________ (Please add names as needed.) Northern Forest Explorers 2016 Registration Form REQUEST FOR SCHOLARSHIP If you are applying for a scholarship please do NOT send money. Upon review of your application you will be contacted with information on the amount of scholarship awarded and to confirm payment of any remainder. Thank you. Northern Forest Explorers connects young people to the great outdoors through participation in active recreation in incredible settings on the Northern Forest Canoe Trail. A central feature of our work is to connect young people living along the Trail to the wonders of their “backyard” waterways and landscapes. To this end, partial and full scholarships are available on a first come, first served basis for residents from communities along and near the Northern Forest Canoe Trail. It is our goal that no child be turned away because of hardship or need so please consider applying if circumstances require help. All fees collected are used to keep these trips running each summer and help support scholarships for participants in need. Your generosity is welcome! If you have any questions regarding financial support, please contact Marthe Peterson at [email protected] or (802) 496-2285 x5. Participant Name: ________________________________________________________________________ Trip Location & Date:_______________________________________________________________________ Has the student received aid before?__________________________________________________________ Parent/Guardian: _________________________________________________________________________ Address:_________________________________________________________________________________ Email: ___________________________________________Daytime Phone: _________________________ Number of household dependents:__________________________ Annual family income:____________________________________ Amount of scholarship aid requested: ______$100 or less ______$100–$300 ______$300–$500 Brief Explanation/Description of need (use separate sheet if necessary): The information provided in this application will remain confidential. .
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