2017 SCGS Field Trip Registration Form
Field Trip Timing: November 3rd-5th, 2017
Field Trip Location: Mecca Hills
Contact us at scgs.mgmt@gmail.com
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Attendee Information
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First Name
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Last Name
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Phone Number
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Email
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Address
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Fee Information and Agreement
The Fees for the 2017 South Coast Geological Society Field Trip are as follows:

Regular Member: $175

Student: $100 (First 10 students); $150 thereafter [Email scgs.mgmt@gmail.com for student scholarship code]

Non-Member: $195

Optional: Student Sponsorship: $75

This cost includes camp site fees, food from Dinner on Friday night to lunch on Sunday and everything in between (6 meals total), beverages (beer, wine, water, soda), 5 port-a-potty’s, a printed Road Log book (when finalized), and 2017 Field Trip Guidebook (when published).

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I understand that I will have to pay for the field trip (at a meeting, eventbrite, mail-in check, etc)
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SCGS Field Trip WAIVER
The participant is advised that dangers and hazards may include but are not limited to uneven ground, steep trails, poison oak, heat and cold stress, poisonous reptiles and insects, open flames, uncertain and possible extreme weather conditions, floods, earthquakes, road hazards, sun burn, and landslides on the SCGS field trip planned for November 3-5th, 2017, and does hereby assume any and all risks involved in connection with the field trip and does hereby save and hold harmless SCGS, its volunteer officers and other participants, all claims, losses and damages (including attorney’s fees and any costs involved because of said claims) on account of injury, death, property damage, and inconvenience or loss of money due to delay that may arise, by reason of participant involvement in the field trip. Participant understands that they (the participant) are responsible for carrying their own medical and auto insurance.
I HAVE READ THIS AGREEMENT, I UNDERSTAND ITS CONTENT, AND INTENTIONALLY AND VOLUNTARILY SIGN THIS AGREEMENT.
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Emergency Contact Information
Please complete the emergency contact information for your safety
Name of Emergency Contact
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Phone Number of Emergency Contact
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Miscellaneous Information
Please answer the following questions to the best of your ability.
What days will you attend?
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Dietary restrictions
Are you willing to serve as a Team Leader to act as lead of a group of 10 vehicles, responsible to maintain space between vehicles to protect desert tortoises and ensure trash is picked up at each spot ?
Transportation
Do you have First Aid or EMT training? (for BLM permits)
A copy of your responses will be emailed to the address you provided.
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