2024 Range Camp Application

✻ = Required

First Name: ✻

Last Name: ✻

Gender: ✻

Date of Birth: ✻

Preferred Name: ✻

Address: ✻

Town ✻

State: ✻

Zip Code: ✻

County in CA/HI: ✻

Home Phone: ✻

Cell Phone: ✻

Email Address for camper (Not School email please): ✻

High School: ✻

Grade (in Spring 2024): ✻

T-Shirt Size: ✻

Small Medium Large X-Large XX-Large

Disclaimer: Camper participation is required during all Range Camp activities. Activities include moderate hiking in grassland or forested areas. Please note any allergies to grass or pollen.

Allergies (including food allergies): ✻

Special Dietary requirements (vegetarian, health restrictions, etc.):

Anything else we can do to help make this the best Camp for you:

EMERGENCY POINTS OF CONTACT

Provide at least two Points of Contact, each with at least two phone alternatives (i.e., home and cell, work and cell, or home and work) and an email address. You may indicate “same” if phone numbers for the Secondary Point of Contact are the same as the Primary.

Primary Point of Contact

First and Last Name: ✻

Relationship: ✻

Phone Numbers:

Home:

Work:

Cell:

Email Address

Secondary Point of Contact

First and Last Name: ✻

Relationship: ✻

Phone Numbers:

Home:

Work:

Cell:

Email Address:

RANGE CAMP REGISTRATION FEE

The $750.00 camp fee must be paid by the application deadline. Applicants can withdraw until May 24. 2024, without a penalty. Thereafter, a $100.00 charge will be retained from the camp fee. Refunds will not be given for cancellations made after June 7, 2024, or for withdrawals while at camp. Those who have received sponsorships may be responsible for reimbursing sponsors in the event of a late cancellation or premature departure from camp.

Please check yes if you have received a sponsorship for Range Camp. If so, please submit the Range Camp Sponsor Form.

Yes No

Please check yes if the applicant is looking for financial assistance and needs help finding a sponsor in order to attend camp. If the box is checked, Range Camp Staff will contact you.

Yes No

We have a grant to sponsor ten campers who qualify under United State Department of Agriculture's definition of "Social Disadvantaged". The definition is found here. If you qualify please self certify and click YES. We will contact you about the scholarship.

Yes No

APPLICANT BACKGROUND INFORMATION

School and community activities:

PAST & CURRENT RANGELAND AND/OR NATURAL RESOURCE-RELATED ACTIVITIES:

(Include hobbies, field-trips, major camping/hiking experiences, ranch or farm work, etc.)

What things related to environmental science, wildlife management, livestock production, botany/plant ecology, and other natural resources and land management practices are you interested in learning about?

Camp is open until full. Camper Applications will be evaluated and accepted based on the information provided in the application. Applications received after the deadline will be evaluated and accepted based on available space. In the event enough applications are received to meet camp capacity a standby list will be created. Contact rangecamp@ucanr.edu to learn whether spaces remain.

MAY 10, 2024 Notification of Acceptance Range Camp will contact you via email with additional information regarding your application and acceptance. Please be sure to provide accurate email addresses.

MAY 24, 2024 Applicant Withdraw Date Applicants can withdraw until this date without a penalty and will be refunded in full. Withdrawals between May 24^th through June 6^th will be refunded a portion of the camp fee, $100 will be retained to cover camp expenses already incurred. Refunds will not be given for cancellations made after June 7, 2024 or for withdrawals while at camp.

JUNE 16, 2024 at 1:00pm Camper Registration/Drop-off

JUNE 21, 2024 at 10:00am Camper Pick-up

PAYMENT: Please ensure payments are made by the Application Deadline through the Range Camp Payment survey linked HERE. Checks can be submitted to 3800 Cornucopia Way, Ste A, Modesto, CA 95358 and should be made payable to: UC Regents

Questions? Contact Theresa Becchetti at 209-525-6807, rangecamp@ucanr.edu

For additional information please visit our website: https://ucanr.edu/sites/rangecamp/

Please be sure to upload the Photo Release and Health Forms, located on this page

Upload your file(s)