Indigenous Science Camp 2024 Sue-Meg

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Local Tribes and Non-profits are hosting a free Youth & Families Indigenous Science Camp on July 22nd at Sue-Meg State Park from 9 am to 4pm. Additional details will be emailed to all registrants prior to the event. Lunch and snacks will be provided. **If you have dietary restrictions or allergies, please bring food for yourself. We cannot guarantee that we will have something that will fit all restrictions.

Filling out this application is required! Please fill out this form to secure your party's space. Please contact Star Gibbens via email at Star@californiasalmon.org with any questions regarding this camp. We look forward to seeing you there!

This event is funded in part by Sierra Health Foundation's Elevate Youth California Grant. The following questions are a necessary aspect of the grant requirements. This information will only be shared internally and will otherwise be deleted.

**PLEASE FILL OUT ONE FORM PER PERSON in your group** We appreciate you taking the time to fill in your responses.

Email *

First Name *

Last Name *

Address *

Phone Number *

How do you identify? *

Male (he/his)

Female (she/her)

Non-binary/Gender non-conforming (they/them)

Prefer not to answer

Other:

Required

Are you part of the LGBTQIA2S+ community? *

Yes

Prefer to self-define

Prefer not to answer

What ethnicity(ies) are you? *

Native American or Alaska Native

Asian: Chinese

Asian: Japanese

Asian: Filipino

Asian: Korean

Asian: Vietnamese

Asian: Asian Indian

Asian: Laotian

Asian: Cambodian

Asian: Other

Black or African American

Hispanic, Latino/a, or Spanish origin

Middle Eastern/North African

Native Hawaiian or Pacific Islander: Native Hawaiian

Native Hawaiian or Pacific Islander: Guamanian

Native Hawaiian or Pacific Islander: Samoan

Native Hawaiian or Pacific Islander: Other

White

Multi-ethnic origin, ethnicity or race

Decline to State

Required

How old are you? *

0-11

12-17

18-20

21-26

27 or older

Are you housing insecure?

Yes

Unsure

Clear selection

Are you in foster care?

Yes

Prefer not to answer

Clear selection

Are you impacted by Juvenile or Criminal Court? *

Juvenile Court

Criminal Court

Not impacted

Required

What is your primary language?

English

Spanish

Other:

Clear selection

Do you have any Tribal Affiliation? *

Karuk

Yurok

Hupa

Tolowa Dee-Ni'

Wiyot

Shasta

Wintu

Modoc

Klamath Tribe

Pit River

Maidu

Pomo

Other:

Required

Do you have any food allergies? If so, please describe/list below.

Do you need transportation

Yes

Clear selection

Will you be staying over night?

Yes

Clear selection

Will you need a tent?

yes

Clear selection

Will you be attending with family

Yes

Clear selection

Do you need ADA accommodations?

Yes

Clear selection

What grade are you in? *

7-9

10-12

College

Trade School

None

Other:

Do you need travel support to drive your own vehicle? *

Yes

Thank you for taking the time to register!

Please fill out a registration form for each member of the family who plan to attend!

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