Full Name *
Full Name
Mailing Address *
Mailing Address
Cell Phone *
Cell Phone
Home/Alternate Phone
Home/Alternate Phone
To receive a $250 scholarship please tell us about your interest in this Field School.
During Jack Creek Preserve Foundation events, photos or videos of attending participants are often taken for use in promotional materials for the Preserve. Neither your name nor any other identifying information will be made available in any way. I hereby give full consent to Jack Creek Preserve Foundation to copyright or publish all videos and photographs in which the participant may appear. The participant hereby gives consent for release of all video and photographic materials and waive any right to inspect or approve of the finished product. *
Please check the box below to give photography permission