GUTS! 2022 Summer Outdoor Adventures Application (part 1)
Part 1 should be filled out by parent/guardian of camper. Part 2 should be filled out by camper.
BOTH MUST BE FILLED OUT FOR A COMPLETE APPLICATION.
Part 2 here: https://forms.gle/3eQJ15kUPWHjYhKy6

GUTS! Summer Adventure Schedule:
June 20-25 : Rising 5th and 6th Graders
July 11-15: Rising 7th and 8th Graders [CANCELED]
July 25-29: Rising 5th and 6th Graders
August 8-12: Rising 7th and 8th Graders
*age ranges are flexible depending on registration demand*

GUTS! welcomes girls, non-binary, transgender, two-spirit, and gender diverse youth.

This year we are offering four outdoor adventure DAY camps that will stay local to Missoula, MT and run Monday-Friday, 8:30am - 4:30pm. Drop off and pick up will take place every day at YWCA’s facility, The Meadowlark, 1800 S. 3rd St. W.

Each day the group will travel to different destinations around town via bike to experience a variety of outdoor and community activities. Some of our community partners this year are Freecycles, Garden City Harvest, Freestone Climbing, Love Boat Paddling CO., Home Resource, and the Natural History Center. Along the way, our staff will also lead GUTS! activities designed to help participants develop healthy relationships with themselves, their bodies, and their peers. We're excited for you to join us!!

Please contact Jess Monis, GUTS! Program Coordinator at jmonis@ywcaofmisoula.com or (406) 543-6691 for any questions.

Sign in to Google to save your progress. Learn more
Camper First & Last Name *
Birth Date *
MM
/
DD
/
YYYY
Age at Camp *
Gender *
Pronouns (she/her/hers, he/him/his, they/them/theirs, etc.)
Which of the following best represents the participant's racial or ethnic heritage? Choose all that apply. *
Camper cell phone number (if they have one)
Camper email (if they have one)
School Attended in Spring 2022 *
Grade completed before summer *
Does the camper qualify for free or reduced lunch program at school? *
FIRST & LAST Name of Parent/Guardian #1 *
Relationship to Camper *
Address of Parent/Guardian #1 *
City *
State *
Zip *
Home Phone of Parent/Guardian #1 *
Cell Phone of Parent/Guardian #1 *
Email of Parent/Guardian #1 *
FIRST & LAST Name of Parent/Guardian #2
Relationship to Camper
Address of Parent/Guardian #2
City
State
Zip code
Home Phone of Parent/Guardian #2
Cell Phone of Parent/Guardian #2
Email of Parent/Guardian #2
Additional Emergency Contact Name (in the event the adult listed above cannot be reached) *
Relationship to Camper *
Emergency Contact Phone # *
Preferred Trip *
Does the participant have a functioning bike that is NOT single speed? *
Does the participant have a bike helmet? *
We want to ensure that every participant is able to attend a summer trip regardless of ability to pay. We ask that applicants self-identify their household income. Please consider the following and use it as a reference.
185% of the federal poverty rate is as follows:
1 in household earning less than $25,142
2 in household earning less than $33,874
3 in household earning less than $42,606
4 in household earning less than $51,338
5 in household earning less than $60,070
6 in household earning less than $68,802
7 in household earning less than $77,534
8 in household earning less than $86,266

The full tuition for Summer Outdoor Adventures is $200; however, we offer a sliding scale based on your financial situation. A deposit of at least half the total cost you plan to pay is due with this application. The full amount of what you plan to pay is due by June 4th. Checks payable to the YWCA Missoula. *
If you answered "scholarship" how much can you contribute towards the cost?
Deposit required unless you selected "unsure" above. Follow the link below to submit your payment.
https://interland3.donorperfect.net/weblink/WebLink.aspx?name=E341298&id=39 
Cancellation Policy :
Cancellations less than 30 days before trip departure result in loss of 100% of your tuition. Cancellations at least 30 days before a trip will be fully refunded. YWCA Missoula will not refund or reduce tuition for late or non-arrival, early withdrawal or participant cancellation for any cause.
Medical and Personal History

If you would prefer to discuss any of these questions with GUTS! staff directly please indicate that.
Please check the box if your child has experienced any of the following:
Please explain any boxes you checked above
Any other relevant medical issues?
Allergies?
A breakfast snack will be provided for ALL participants by the food bank. Lunch MUST be provided by the caregiver.  Can you please describe your child’s eating habits: *
Please describe any physical and or emotional conditions that might affect the camper’s ability to participate in outdoor activities like biking, rafting, and climbing. If so, what restrictions or accommodations will need to be made?
Has the camper had a significant life event happen that continues to affect their life? (history of abuse, death of a loved one, family change, adoption, disaster, etc.)
Describe any outdoor experience the camper has had in the past. *
How does the camper do in group and social settings? How does your child do in school environments? *
What comfort level fits your child best when biking long distances? *
If your child does not exercise regularly, what is their plan to prepare for the camp? *
What role did your camper play in choosing us? How do they feel about attending? Any special convincing needed? *
Do you or your child have any concerns about attending a GUTS! camp?
Anything else you would like to share with us?
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms