22nd Annual Outdoor Women’s Program · #88, 4003 - 98 Street Edmonton, Alberta T6E 6M8 Phone:...
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Name: Address: City: Province: Postal Code: Home Phone: Work Phone: Cell Phone: Email Address: Have you attended the OWP previously? No Yes If so, how many times? Yes, I would like my name and email address to be listed on the 2015 Attendance Summary and circulated to fellow OWP Participants at the camp (please check box) Registration Specifics: The workshop fee includes all instruction, program materials, use of demonstration equipment, meals, and evening programs. There is an additional $25.00 fee for the Canadian Firearms Course. There is an additional $30.00 material fee for the Making Leather Moccasins session (to be paid at the commencement of the session) Program Cost Wednesday Aug-05 Thursday Aug-06 Friday Aug-07 Saturday Aug-08 Sunday Aug-09 Early Bird Price After June 26 Wed to Fri √ √ √ $ 150.00 $ 170.00 Thurs & Fri √ √ $ 140.00 $ 160.00 Sat & Sun √ √ $ 145.00 $ 165.00 Wed to Sun √ √ √ √ √ $ 250.00 $ 270.00 Total Workshop Fee (Use table above) $ Firearms Safety Course Fee - $25.00 (if applicable) $ GST (5%) $ Total Fees Due $ I wish to reserve the following accommodations: Cabin RV Space RV Size: Tent Space No Accommodation *There is no charge for any accommodations IF we are able to accommodate this request, do you have a preference as to whom you wish to share accommodations with? If so, please list their names below: Your Registration Includes a Complimentary T-Shirt! Your t-shirt will be with your registration package when you arrive at camp. Please indicate your t-shirt size: Small X - Large Medium XX - Large Large My cheque is enclosed and payable to Alberta Hunter Education Instructors’ Association Please charge my Visa credit card or MasterCard: Card #: Date: Expiry: / Signature: 22nd Annual Outdoor Women’s Program Registration Form Page 1 of 3
Transcript of 22nd Annual Outdoor Women’s Program · #88, 4003 - 98 Street Edmonton, Alberta T6E 6M8 Phone:...
Name:
Address:
City: Province: Postal Code:
Home Phone: Work Phone: Cell Phone:
Email Address:
Have you attended the OWP previously? No Yes
If so, how many times?
Yes, I would like my name and email address to be listed on the 2015 Attendance Summary and circulated to fellow OWP Participants at the camp (please check box)
Registration Specifics: The workshop fee includes all instruction, program materials, use of demonstration equipment, meals, and evening programs.
There is an additional $25.00 fee for the Canadian Firearms Course. There is an additional $30.00 material fee for the Making Leather Moccasins session (to be paid at the commencement of the session)
Program Cost Wednesday
Aug-05
Thursday
Aug-06
Friday
Aug-07
Saturday
Aug-08
Sunday
Aug-09
Early Bird
Price
After
June 26
Wed to Fri √ √ √ $ 150.00 $ 170.00
Thurs & Fri √ √ $ 140.00 $ 160.00
Sat & Sun √ √ $ 145.00 $ 165.00
Wed to Sun √ √ √ √ √ $ 250.00 $ 270.00
Total Workshop Fee (Use table above) $
Firearms Safety Course Fee - $25.00
(if applicable) $
GST (5%) $
Total Fees Due $
I wish to reserve the following accommodations: Cabin RV Space RV Size: Tent Space No Accommodation *There is no charge for any accommodations
IF we are able to accommodate this request, do you have a preference as
to whom you wish to share accommodations with? If so, please list their
names below:
Your Registration Includes a
Complimentary T-Shirt! Your t-shirt will be with your registration package when you
arrive at camp. Please indicate your t-shirt size: Small X - Large Medium XX - Large Large
My cheque is enclosed and payable to Alberta Hunter Education Instructors’ Association
Please charge my Visa credit card or MasterCard:
Card #: Date:
Expiry: / Signature:
22nd Annual Outdoor Women’s Program
Registration Form Page 1 of 3
Name:
Please number at least 14 sessions of your choice numerically (i.e. 1 to 14), In the order of your preference (1 being most preferred).
Please ensure that you are selecting sessions that are available during your attendance **If the registrant is a youth, they must attend with a parent or legal guardian, and the youth and adult must participate in all sessions jointly.**
Session
Availability
WED THURS FRI SAT SUN
Advanced Hunting — Upland Game Birds and Waterfowl PM
Advanced Hunting — Big Game Animals AM
Archery AM AM AM AM
Arrow Crafting PM PM PM
Backpacking 101 AM/PM AM/PM
Build your own Survival Bracelet AM/PM AM AM/PM AM
Canadian Firearms Safety Course AM/PM
Canoeing — Advanced PM PM PM
Canoeing — Basic AM AM AM AM
Chainsaw Basics AM/PM AM/PM AM
Crossbows — Getting Started AM/PM AM/PM AM
Field Techniques AM/PM AM/PM AM/PM AM
Firearms Basics — Guns, Guns, Guns AM AM AM AM
Fly Fishing AM AM AM AM
Geocaching AM AM AM AM
Get Out Alive AM/PM AM/PM AM/PM AM
Handguns PM PM PM
Introduction to ATV’ing AM/PM AM/PM AM/PM AM
K-9’s at Work –Search & Rescue Dogs AM
Let’s Go Bowhunting PM PM PM
Making Leather Moccasins AM/PM AM/PM AM/PM
Muzzleloading PM PM
Photography Outdoors AM/PM AM/PM
Predator Awareness AM/PM AM/PM AM/PM
Stranded on the Road AM/PM AM/PM AM/PM AM
The Science of Fishing PM PM PM
Trailering AM/PM AM/PM
Walk on The Wild Side AM/PM AM/PM
Where am I? Where Should I be? PM PM PM
Wilderness Cuisine AM/PM PM AM/PM AM
Wilderness First Aid AM/PM AM/PM AM/PM AM
Wilderness Survival — Part 1 PM
Wilderness Survival — Part 2 AM
Wildlife Identification AM/PM AM/PM AM
22nd Annual Outdoor Women’s Program
Registration Form Page 2 of 3
22nd Annual Outdoor Women’s Program
Registration Form Page 3 of 3
PLEASE COMPLETE THIS FORM AND SEND TO:
Alberta Hunter Education Instructors’ Association
#88, 4003 - 98 Street Edmonton, Alberta T6E 6M8
Phone: 780-466-6682 or 1-866-282-4342 Fax: 780-431-2871
Email: [email protected] or [email protected]
Registration Forms are also available on-line at www.aheia.com or www.huntingfortomorrow.com
In the event of an emergency or evacuation please provide the following necessary information:
Emergency Contact:
Name:
Phone(s):
AUTHORIZATION: In the event that my emergency contact cannot be reached, I give permission to the organizers of the
Outdoor Women’s Program to secure any necessary treatment in the case of an emergency and /or accident.
Signature: X
Date:
Vehicle Information: Make/Model/Year:
Color: License Plate:
Name:
Date of Birth: MMMMMM /// DDDDDD /// YYYEEEAAARRR
List all prescription and non-prescription medicine currently being taken:
List of any allergies (food, medicine, insect stings, etc). Please note we are unable to accommodate for food allergies at the camp:
Describe any physical conditions that will require special assistance during the OWP:
Medical History: Check any of the following conditions you currently have or ever had:
Asthma Back Surgery Stroke Heart Problems
Migraines Diabetes Seizures Chronic Back Problems
If Diabetic, are you insulin dependent? Yes No
Do you wear contact lenses or glasses? Yes No
Have you ever had a tetanus immunization within the past year? Yes No
Participant Signature Required: X By signing above, I recognize this event involves risk and I take responsibility for action or injury that may result by participating. I agree to the
following program policies:
· The Alford Lake Centre is a drug and alcohol free area.
· Anyone consuming and/or under the influence of alcohol or drugs will be required to leave our facilities.
· Cancellation prior to July 17, 2015 entitles me to a full refund, less a $50.00 administration charge.
· No refunds are provided after July 17, 2015.
· Confirmation letters and your receipt will be mailed by the end of July.
