Bird Scouts Registration
Bird Scouts is an outdoor program for youth and families. Activities will be available every-other-month at the Harney County Library. Youth will have two months to complete the activities, participate in the community science project, or create their own art pieces. Youth that complete the "Earn Your Patch" activities will earn a bird patch. The third Saturday of every month there will be an optional bird walk for Bird Scouts youth and their families.
* Required
Child's First Name
*
Your answer
Child's Last Name
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Your answer
Parent or Guardian's First Name
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Your answer
Parent or Guardian's Last Name
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Your answer
Parent or Guardian Email
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Your answer
Parent or Guardian Phone Number
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Your answer
Parent or Guardian Address
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Your answer
Emergency Contact Name
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Your answer
Emergency Contact Phone Number
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Your answer
Grade
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3rd
4th
5th
6th
Other:
Required
PHOTO/VIDEO RELEASE: Portland Audubon has my permission to use photos or videos of me or my child in publications and promotional materials. No names will be used and all due diligence will be taken to protect you and your child.
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Yes
No
Required
Though our (COVID-safe) in-person programs (e.g. Bird Walks, etc.) will not be drop-off (i.e. an adult will need to attend with their youth) there may be instances where medication or medical care will need to be provided by Portland Audubon staff. We also want to make sure we honor our Bird Scouts when we do interact with them in-person. Because of this, please answer the following questions:
Please list any allergies your child has:
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Your answer
I give my permission for Portland Audubon staff to provide first aid for the child named above and to take the appropriate measures including contacting the Emergency Medical System and arranging for transportation to the Harney District Hospital. I agree to indemnify and hold Portland Audubon, its officers and employees, harmless from claims of losses for any bodily injury or property damage which occurs or is alleged to have occurred as a result of negligence of participant. Please check the medications that your Bird Scout CANNOT be given
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Acetaminophen (Tylenol, etc.)
Ibuprofen (Advil, etc.)
Oral antihistamine (Benadryl, Zyrtec)
My child can take all of these
Required
Please list any medications we should know your Bird Scout is taking:
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Your answer
Is there any other information that we should know about your Bird Scout? For example: gender pronouns (e.g. she/her, they/them), nicknames, etc.
*
Your answer
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