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SCHOOL
School/Organization Requesting Program *
TEACHER OR GROUP LEADER CONTACT INFORMATION
First Name *
Last Name *
Phone *
Email *
PARTICIPANT INFORMATION
Grade or Age of Participants *
No. of Program Participants *
No. of Teachers or Group Leaders *
No. of Parents or Volunteers *
KIDS AND YOUTH EDUCATION PROGRAM TOPICS
Kindergarten to Grade 3 --Nature's NotionsThe Science of SnowMarvellous Misunderstood BatsExploring Cardinal DirectionsBugology
Grade 4 to 6 --TreelympicsNature's RecyclersMetis TraditionsFur Trade ExperienceThe Wonders of Wetlands
Grades 5 to Grade 9 --Introduction to Outdoor SurvivalOutdoor LeadershipTrees and ForestsEvidence and InvestigationEcology and Biodiversity StudyAction For Energy (Multiple Modules)Eagle Point River StudyWilderness Primer (Multiple Sessons)
General Interest --All About BirdsTracks n' ScatsAn Introduction to GeocachingInterpretive Walk and Nature JournalsNature CraftsOutdoor GamesFurs, Skulls and AntlersOwl DiscoveryCitizen Science Project
IF APPLICABLE, SELECT YOUR ACTION FOR ENERGY OR WILDERNESS PRIMER SESSION
Action for Energy Program Modules --Module 1 - Climate Literacy Presentation and Solar Over ConstructionModule 2 - Exploring Energy Efficiencies and Solar PanelsModule 3 - Exploring Circuit Meter Technology In Real-Time!Module 4 - The Action for Energy Game (table top game or giant floor game)Module 5 - The Action for Energy Movie (YouTube) + 12 Classroom ChallengesModule 6 - Climate Literacy Presentation and Water Treatment Facility Tour
Wildnerness Primer Program Sessions --Session 1 - An Introduction to Gear and ClothingSession 2 - Bears, Bugs & Big CatsSession 3 - Navigation 1 - An Introduction to CompassesSession 4 - Navigation 2 - Compasses, Maps & OrienteeringSession 5 - Woods Travel - Hiking or SnowshoeingSession 6 - Fire Starters and Fire LightingSession 7 - KnotsSession 8 - Camp ToolsSession 9 - Emergency Shelters and First AidSession 10 - Hygiene, Cooking and WaterSession 11 - Setting up your Campsite
EQUIPMENT RENTALS
Do You Require Snowshoe Rentals * NoYes
DATES AND TIMES
Date Requested *
Alternate Date *
Note: It is recommended that booking requests are made months in advance due to high demand.
Arrival Time *
Departure Time *
Program Location/Facility * ClassroomWilley West CampgroundPembina Nordic CentreRotary/Pembina Community TrailsOther - Please Specify
Will there be adults with First Aid Certification present? * YesNo
Will there be any participants with medical conditions (i.e. Allergies, disabilities, asthma etc). Please elaborate *
Other Comments?
I agree to the terms and conditions stated above and in the “Key Messages for School Groups”. I understand that transportation to/from locations is the responsibility of the school or organization unless otherwise agreed to by both parties. * YesNo
Disclaimer: Transportation will NOT be provided. It is up to the school/organization to organize this service.
TEACHER OR GROUP LEADER AUTHORIZATION
Date *