With thanks to our corporate sponsors:
Halstead & Associates
Environmental/Biological Consultants
Wilderness Unlimited
22425 Meekland Ave.
Hayward, CA 94541
Safari Club International,
Golden Gate Chapter
272 Castle Crest Rd.
Alamo, CA 94507
Rocky Mountain Elk Foundation
1-800 Call Elk
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Please fill out the following information for us. When you click submit, you will be redirected to select your workshop.
With thanks to our corporate
sponsors:
Canyon Sports
887 Howe Rd, Suite F
Martinez, CA 94553
(950) 299-4867
Sage Fly Fishing Gear
by Leland Outfitters
National Rifle Association
of America
11250 Waples Mill Rd.
Fairfax, VA 22030
California Deer Association
820 Park Row
PMB 671 Salinas, CA 93901-2406
BOW, California Online Registration
Personal Information
Choose Workshop
Cancellation Policy
If you cancel three weeks or less prior to the workshop date, you will forfeit 100% of your registration unless you provide a replacement, or someone on the waiting list accepts your spot.
I have read and understand the Cancellation Policy.
Medical History Form
All information is confidential and will only be released in the event of a medical emergency.
Emergency Medical Authorization
Liability Release
Name:
Mailing Address:
City:
State:
Zip:
Mobile Phone:
Other Phone:
Email Address:
Preferred Shirt Size (only for Multi-Course Workshop):
Initial Here:
Date of Birth:
Physician:
Physician's Phone Number:
Emergency Contact Name:
Relationship:
Are you allergic to any medication (Penicillin, Aspirin, etc.)?
Emergency Contact's Phone Number:
Have you ever been told by a doctor that you have epilepsy?
Have you had recent surgical operations, accidents or injuries?
Have you been knocked unconscious, had a concussion or a head injury?
Are you pregnant?
Do you wear glasses?
Do you wear contact lenses?
List:
When?
When/What?
When?
Expected delivery date:
Please check any of the following medical conditions you have had within the last five years:
List specifics:
Do you have any medical training?
Other:
Is there anything else about your health you would like us to know in case of an emergency?
I certify that the above is true (initial):
The attached health history questionnaire is correct to the best of my knowledge, and I am able to engage in all activities, except as noted by me and a physician. In the event of an emergency, I hereby give permission to a physician to hospitalize, secure proper anesthesia, or to order injection or surgery, or other medical procedures required by the emergency situation.
I give consent for the staff of Becoming an Outdoors-Woman, California (hereinafter BOW California) to provide medical attention, transportation, and emergency medical services as warranted by the circumstances.
I represent that I am in good physical condition, and I am not aware of any disease or injury that would be aggravated or result in my being incapacitated or injured during any program participation, except as designated herein.
If I am injured, or suffer any illness or disease while residing at and participating in programs of BOW California, I agree to hold BOW California harmless for any said injury, illness, or disease.
I further understand and agree to abide by the general rules of conduct prescribed for guests, and understand that violations will result in a denial of privileges, a forfeiture of all fees paid, and immediate removal from the grounds where the program is being conducted.
I have read this release, and I understand it affects my legal rights and responsibilities. I hereby agree and consent to its terms and conditions and waive any claims arising while residing/participating in programs of BOW California.
Initial:
Initial:
