Wild Turkeys Registration, 2018-19
Please complete one form for each child you are registering.
Contact Info
Child First Name *
Your answer
Child Last Name *
Your answer
Address (Street) *
Your answer
Address (Town/City) *
Your answer
Address (State/Province) *
Your answer
Address (Zip) *
Your answer
Address (Other Info)
Your answer
Gender
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Age on 1st day of program *
Your answer
Family Info
First Name of Parent or Legal Guardian 1 *
Your answer
Last Name of Parent or Legal Guardian 1 *
Your answer
Email *
Your answer
Primary/Cell Phone 1 *
Your answer
Home/Other Phone 1
Your answer
Relationship
First Name of Parent or Legal Guardian 2
Your answer
Last Name of Parent or Legal Guardian 2
Your answer
Email
Your answer
Cell Phone 2
Your answer
Home/Other Phone 2
Your answer
Relationship
Sibling names and ages
Your answer
Questionnaire
(Returning families may choose to answer or skip these questions)
How much time does your child spend outdoors?
Where does your child go to school (or are they homeschooled)?
Your answer
What passions/interests will your child bring to this program? What do you particularly want your child to gain from the program?
Your answer
Please describe your child's experience with wilderness and naturalist skills including day or overnight programs attended and/or experience with mentors. How does your child feel about coming to Wild Turkeys? (excited, anxious, worried, etc.)
Your answer
How does your child interact with other children one-on-one and in a group? At home? At school?
Your answer
How does your child interact with adults? Please address listening skills and ability to follow directions.
Your answer
Does your child have any medical, physical, intellectual or emotional conditions that may effect his/her ability to participate in this program? If so, please describe.
Your answer
Anything else you want to us to know?
Your answer
Scholarship Application
The Vermont Wilderness School's Great Blue Heron Fund provides tuition reductions for this and other VWS programs. The average scholarship rate we offer is 20-30% off the low end of the sliding scale. Scholarship requests are August 1st, but the earlier you make your request the better. We will reply by August 10th.
$ Amount of scholarship funds I am requesting:
Your answer
Please share any information you choose about your scholarship request.
Your answer
Payment
$ Program Fee for this Single Registration *
Sliding Scale: $640 – $865. Actual per-student cost is $765.
Your answer
$ My Donation to the Scholarship Fund
The Great Blue Heron Fund provides scholarship funds to this and other VWS programs. Consider donating the full cost of another child's tuition! Your donation is tax deductible.
Your answer
$ Total I Owe *
Program Fee +PLUS+ Donation
Your answer
$ Amount I am paying TODAY for this single registration *
A deposit of $150 is required to reserve a slot. Full payment is due September 15.
Your answer
I will be paying today via: *
If you will be using a PayPal Payment account associated with a different name than the one used in this registration, please let us know!
(This helps us associate your payment with your registration.)
Your answer
How did you hear about Wild Turkeys?
Your answer
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