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CRITFC Salmon Camp Application

CRITFC Salmon Camp Application

Application must be received by April 30, 2023 for consideration. There is no cost to attend Salmon Camp, but only has capacity for twenty students (five from each of the four CRITFC member tribes).

Camp Conditions

Salmon Camp is a five-day/four-night camp. The weather will be hot and sunny during the day, and possibly chilly at night. It is strongly suggested that students leave all valuables at home (video games or other electronic devices, money, jewelry, etc). CRITFC is not responsible for any lost, damaged or stolen property. CRITFC staff will have cell phone service.

Transportation

It is the responsibility of the parents or guardians of camp attendees to get their child to and from the designated check-in and pick-up locations. Details and locations will be provided to campers upon selection.

Instructions

Fill out this application in full. It includes:
1. Application Form
2. Emergency Contact and Medical Information
3. Student Essay
Parental permission, student agreement, and health care information/medical release forms will be sent in a welcome packet to students who are selected.
You may also download the application form here. It can be filled out in Microsoft Word or printed and filled out physically. (Please print or type in black or blue ink.)
If you have questions or need assistance filling out the application, please contact: Laura Gephart at (503) 238-0667 or salmoncamp@critfc.org

The deadline for submitting an application is Sunday, April 30, 2023.

Salmon Camp 2023 Application

Application must be received by April 30, 2023 for consideration. There is no cost to attend Salmon Camp, but only has capacity for twenty students (five from each of the four CRITFC member tribes).

"*" indicates required fields

1Student Information

2Emergency Contact and Medical Information

3Salmon Camp Essay

Name*

First Last

Date of birth*

Tribal Affiliation*

Gender*

Name of Parent/Guardian*

Grade in FALL 2023 School Year*

Salmon Camp is open for incoming 6th and 7th grade students.

Previous Salmon Camp attendee?*

Mailing Address*

Address City State ZIP Code

Phone*

Email*

Emergency Contact and Medical Information

List two emergency contacts (adults) and their contact information.

Emergency Contact #1*

Primary Phone*

Other Phone

Emergency Contact #2*

Primary Phone*

Other Phone

Applicant has health care coverage?*

Yes

No

Applicant has proof of COVID vaccination?*

Yes

Not yet but will complete vaccination series before the start of Salmon Camp

No

Note: All Salmon Camp participants, counselors, junior counselors, presenters, and staff interacting with the students will require COVID vaccinations. Applicants who are not vaccinated from COVID will not be considered.

Students who are selected for Salmon Camp will be required to provide doctor contact information and insurance policy numbers. A medical information and release form will be included in the student's welcome packet.

Please indicate any medical conditions, medications, allergies, dietary needs, behavior issues, learning or physical disability, or special conditions that CRITFC staff should be aware of (attach additional sheet if necessary):

Student Ability Certification

To be initialed by a parent or guardian.

I verify applicant, to the best of my knowledge, will be able to handle 5 days and 4 nights away from home.*

INITIALS

I verify applicant is able to safely participate in aquatic activities. (swimming, rafting, etc.)*

INITIALS

Certification

Please read carefully before entering your name. By doing so, you understand that this is a preliminary application and not a guarantee for camp participation. Physical signatures will be requested after student is accepted to camp. I hereby certify that all of the information provided by me in connection with my application is truthful, accurate, and complete to the best of my knowledge.

Applicant Name*

Parent/Guardian Name*

Consent and Release Agreements

Upon acceptance to the 2023 Salmon Camp, a Parent/Guardian consent and medical release agreement and a student agreement will be sent in a welcome packet for signature.

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CRITFC Salmon Camp Application

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Salmon Camp 2023 Application

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