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Wilderness Institute Citizen Science Program Volunteer Application Form

Thank you for your interest in volunteering with the Wilderness Institute's
Citizen Science Program




Please complete the following form, answering questions as completely as possible.  


We will review the information you provide us and will reply to let you know if your application to volunteer is accepted, and you are registered, or, if we need additional information. 


If you have any questions please contact Rachel James, Citizen Science Program Outreach Coordinator, citizenscience@cfc.umt.edu (406) 243-6916.
 
 
1. PLEASE NOTE THAT WE WILL BE ADDING TRIPS THROUGHOUT THE SUMMER, CHECK BACK OFTEN FOR MORE TRIPS!
Please provide us with your contact information: *This question is required.
2. To volunteer with the Wilderness Institute's Citizen Science Program you must be 18 years old or older, or accompanied by a parent or gaurdian.  Please select one of the following which best describes you:
4. How did you hear about the Citizen Science Program?
5. Please select the project(s) you are interested in volunteering for*:
*Please check back periodically throughout the summer as we may add more trip opportunities!
Physical Condition and Preparedness for Volunteer Trips.
This section of the Wilderness Institute's Citizen Science Program volutneer application is to determine if you are physically capable of engaging in the requirements of the volunteer activities in remote mountain settings, a significant distance from difinitive medical care. We also ask these questions to determine if there is medical information that is important for field leadres to know. The answers will be confidential, and only viewed by field leaders and adminstrative support staff.  
8. You are required to have medical insurance to participate in a volunteer trip.  Please provide details below.
9. Basic physical information
10. In case of emergency, whom should we notify?
11. Have you had a tetanus shot or booster within the previous 10 years?
16. Allergies
Please be sure to inlcude all history of allergic reactions and treatmetns, in your answers below.
23. Do you have any dietary restrictions? 
24. Backpacking Experience
Please help give us a sense of your experience in remote settings.  Check the box that best describes you.
25. Hiking Experience
Please give us a sense of your experience hiking on rough trails.  Our trips will require that you are comfortable and willing to hike several hours with a backpack with your personal gear and food, up to 35 lbs over rolling mountian terrain.
Check all that apply.
27.

THE UNIVERSITY OF MONTANA WILDERNESS INSTITUTE

ACKNOWLEDGMENT OF RISK

In consideration of the services of The University of Montana Wilderness Institute, its employees, contractors and all other persons associated with it (referred to below as the “Wilderness Institute”), I agree and acknowledge as follows (please initial each paragraph):  
           
By participating in programs and/or classes through the Wilderness Institute, I knowingly and willfully assume many risks inherent in traveling in remote wilderness areas.  Through my participation, I will be expected to complete various activities in which risks may be involved, including certain risks that cannot be eliminated without destroying the unique character of program activities.  The same elements that contribute to the unique character of program activities can be the causes of loss or damage to my equipment, accidental injury, illness, or in extreme cases, permanent trauma, disability or death.  Certain inherent risks associated with program activities include but are not limited to: the hazards of highway travel, the hazards of backcountry travel (such as river travel, winter travel, and travel in mountainous and desert terrain), inclement weather, the forces of nature, human error, accidents, illness, environmental hazards and exposure, animal encounters, falling rock, and the physical and mental stresses of hiking, skiing, and canoeing in varying climatic and geographic conditions.  I am also aware that many activities in this program are physically and mentally challenging.  I understand that program activities may occur in remote places, days from medical facilities, and realize that due to the remote setting, evacuations and medical care may be significantly delayed.  I am aware of the inherent risks in wilderness travel, camping, and other wilderness activities and agree to assume responsibility for these risks and those inherent risks not specifically identified. 
 
My participation in this activity is purely voluntary and I elect to participate in spite of and with knowledge of the inherent risks.  I acknowledge that although the Wilderness Institute follows nationally accepted risk management standards, my safety cannot be guaranteed. 
 
I also acknowledge that during program activities decisions are made by instructors, group leaders, and students based on a variety of perceptions and evaluations which by their nature are imprecise and subject to errors in judgment.  There may also be times when students are unsupervised for portions of a field activity, and will ultimately be held responsible for their own safety and for the safety of others to the extent that their actions have bearing.
    
I understand that participation in this program may require a degree of skill and knowledge different from other activities, and that I have responsibilities as a participant.  I understand that the staff and faculty of the Wilderness Institute will provide written materials, hands-on instruction, and be available to fully inform me of the nature and physical demands of program activities and the inherent risks, hazards and dangers associated with these activities, and it is my responsibility to read all materials provided and attend all field and safety instruction throughout the duration of the Wilderness & Civilization program.
    
I have verified with my physician and/or medical professionals that I have no past or current physical or psychological condition that might affect my active participation in this program, other than as described on the Medical Form, and agree to immediately notify the Wilderness Institute of any significant changes relative to the Medical Form.  I authorize the Wilderness Institute to obtain or provide emergency hospitalization, surgical or other medical care for me.
   
In consideration of the right to participate in all activities arranged by the Wilderness Institute as a part of this course or curriculum, I will and hereby do, assume all responsibility for the above-mentioned risks, and those inherent risks not specifically identified.  To minimize the inherent risks, I agree to accept the direction of the group leaders and comply with all Wilderness Institute practices and policies.  In addition, I understand that at any time I participate in any activity against the instruction of the group leaders, that at that time I am no longer part of the Wilderness Institute program and I am acting on my own.
    
By my initials, I am indicating that I have carefully read and agree to the terms set forth by this Acknowledgment of Risk document.
 
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