To be completed by an ADULT. Complete one form per teen by July 10, 2019 <\/strong>\n\nThe Teen programs for 14 - 18 year olds takes place from 8:00 a.m. - 3:30 p.m. daily. Unless the group is on an all day field trip, lunch will be in the usual dining room. On the first regular day of classes, please bring a pen or pencil, small notebook, day pack, water bottle, snack, rain gear, sun screen, sunglasses, and your enthusiasm. Please refer to the Teen Schedule (.docx)<\/a> posted on our website for a more detailed description of what you will need to bring for the week. Also, an email with general information for the week \n along with a schedule of activities will be sent to parents of youth registered in the Teen program by the end of June. \nIf you cannot or do not wish to fill out the online form, please fill out the 2019 Teen Enrollment Fill-In Form (.pdf)<\/a> or \n 2019 Teen Summit Information - Enrollment Form (.docx)<\/a> of the form and email (info@familynaturesummits.org<\/a>), fax (949-743-2567) or by mail to Family Nature Summits, PO Box 104, Norco, CA 92860. \n<\/li>

Participation, Health and Behavioral Policy Acknowledgements<\/p><\/li>

I consent to my son's\/daughter's participation in the Family Nature SummitTM Teen Program. The information below is as complete as possible to help ensure that my teen has the best educational\/recreational opportunity. All information is confidential*<\/span><\/label>
<\/div><\/li>

After making reasonable effort to reach me, the Family Summits, Inc. have my permission, in the event they determine the need exists, to contact our family physician or to take my child to the emergency room of the nearest hospital. The physician and\/or the hospital, as the case may be, have my authorization to provide any treatment which they deem necessary for the well-being of my child.*<\/span><\/label>
<\/div><\/li>

Teen's Information<\/p><\/li>

Teen's Last Name*<\/span><\/label>
<\/div><\/li>

Teen's First Name*<\/span><\/label>
<\/div><\/li>

Teen's Nickname (if applicable)<\/label>
<\/div><\/li>

Address*<\/span><\/label> \n
\n \n \n Street Address<\/label>\n <\/span>\n \n Address Line 2<\/label>\n <\/span>\n \n City<\/label>\n <\/span>\n \n State \/ Province \/ Region<\/label>\n <\/span>\n \n ZIP \/ Postal Code<\/label>\n <\/span>\n \n <\/div><\/li>

Teen's Age at the start of the Summit*<\/span><\/label>
<\/div><\/li>

Date of Birth*<\/span><\/label>
\n \n <\/div>\n <\/li>

Gender*<\/span><\/label>
Male<\/label><\/li>
Female<\/label><\/li><\/ul><\/div><\/li>
Is this your teen's first Summit?<\/label>
yes<\/label><\/li>
no<\/label><\/li><\/ul><\/div><\/li>
How many Summits has your teen attended?<\/label>
<\/div><\/li>
Grade completed at the start of the Summit*<\/span><\/label>
<\/div><\/li>
Is your he\/she a vegetarian?<\/label>
Yes<\/label><\/li>
No<\/label><\/li><\/ul><\/div><\/li>
Any other special diet?<\/label>
<\/div><\/li>
Physician's Name:*<\/span><\/label>
<\/div><\/li>
Physician's phone #:*<\/span><\/label>
<\/div><\/li>
Physician's address:<\/label> \n
\n \n \n Street Address<\/label>\n <\/span>\n \n Address Line 2<\/label>\n <\/span>\n \n City<\/label>\n <\/span>\n \n State \/ Province \/ Region<\/label>\n <\/span>\n \n ZIP \/ Postal Code<\/label>\n <\/span>\n <\/textarea><\/div><\/li><li id='field_3_23' class='gfield field_sublabel_below field_description_below' ><label class='gfield_label' for='input_3_23' >Does your teen have any medical or physical considerations we should know about? Please describe:<\/label><div class='ginput_container'><textarea name='input_23' id='input_3_23' class='textarea medium' tabindex='35' aria-invalid=\"false\" rows='10' cols='50'><\/textarea><\/div><\/li><li id='field_3_26' class='gfield field_sublabel_below field_description_below' ><label class='gfield_label' for='input_3_26' >Does he\/she need any special accommodations required to participate in Summit activities (i.e. for physical or mental disabilities?<\/label><div class='ginput_container'><textarea name='input_26' id='input_3_26' class='textarea medium' tabindex='36' aria-invalid=\"false\" rows='10' cols='50'><\/textarea><\/div><\/li><li id='field_3_30' class='gfield field_sublabel_below field_description_below' ><label class='gfield_label' for='input_3_30' >List ALL ALLERGIES to food, medicine, insects bites or stings, plants and preferred treatment methods or remedies<\/label><div class='ginput_container'><textarea name='input_30' id='input_3_30' class='textarea medium' tabindex='37' aria-invalid=\"false\" rows='10' cols='50'><\/textarea><\/div><\/li><li id='field_3_58' class='gfield field_sublabel_below field_description_below' ><label class='gfield_label' for='input_3_58' >In case of a medical emergency, please describe any special procedures to be followed<\/label><div class='ginput_container'><textarea name='input_58' id='input_3_58' class='textarea medium' tabindex='38' aria-invalid=\"false\" rows='10' cols='50'><\/textarea><\/div><\/li><li id='field_3_57' class='gfield field_sublabel_below field_description_below' ><label class='gfield_label' for='input_3_57' >Does he\/she have any spcial dietary needs that should be considered for off-site trips?<\/label><div class='ginput_container'><textarea name='input_57' id='input_3_57' class='textarea medium' tabindex='39' aria-invalid=\"false\" rows='10' cols='50'><\/textarea><\/div><\/li><li id='field_3_35' class='gfield field_sublabel_below field_description_below' ><label class='gfield_label' for='input_3_35' >Special interests\/hobbies (outdoor and indoor)<\/label><div class='ginput_container'><textarea name='input_35' id='input_3_35' class='textarea medium' tabindex='40' aria-invalid=\"false\" rows='10' cols='50'><\/textarea><\/div><\/li><li id='field_3_36' class='gfield field_sublabel_below field_description_below' ><label class='gfield_label' for='input_3_36' >Does he\/she require any special accommodations?<\/label><div class='ginput_container'><textarea name='input_36' id='input_3_36' class='textarea medium' tabindex='41' aria-invalid=\"false\" rows='10' cols='50'><\/textarea><\/div><\/li><li id='field_3_38' class='gfield field_sublabel_below field_description_below' ><label class='gfield_label' for='input_3_38' >Other helpful information.<\/label><div class='ginput_container'><textarea name='input_38' id='input_3_38' class='textarea medium' tabindex='42' aria-invalid=\"false\" rows='10' cols='50'><\/textarea><\/div><\/li><li id='field_3_17' class='gfield gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below field_description_below' ><p class=\"form1\">Parent's or Guardian's Information <\/p><\/li><li id='field_3_3' class='gfield gfield_contains_required field_sublabel_below field_description_below' ><label class='gfield_label' for='input_3_3' >Parent's or Guardian's Name<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_3' id='input_3_3' type='text' value='' class='medium' tabindex='43' aria-required=\"true\" aria-invalid=\"false\" \/><\/div><\/li><li id='field_3_13' class='gfield gfield_contains_required field_sublabel_below field_description_below' ><label class='gfield_label' for='input_3_13' >Parent's or Guardian's email<span class='gfield_required'>*<\/span><\/label><div class='ginput_container ginput_container_email'>\n <input name='input_13' id='input_3_13' type='text' value='' class='medium' tabindex='44' \/>\n <\/div><\/li><li id='field_3_14' 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