Canyoneering 2020 Pre-Registration Form

Are you a current Mazama Member? *
Are you a competent swimmer? *
I have read and have the prerequisites for this course. (click the "?" to review) * 🛈
I have reviewed the required gear and have, or agree to acquire, the minimum gear required to participate (click the "?" to review) * 🛈
Upon applying, you affirm that all of the checked statements below are true for you:

Deselecting any box does not necessarily disqualify you from being able to participate in this class; we will do our best to provide you with accommodations that you need to succeed in the class, but cannot guarantee our ability to do so. *
I will need financial assistance in order to take this class: *

The Payment Plan option for the Canyoneering 2020 course will allow you to pay 33% of your course fee at the time that you are accepted into the course, and two subsequent payments of 33% of the course fee charged on the first of each subsequent month. 

By selecting "Yes, I will need financial assistance to take this course", you will be automatically enrolled in a payment plan, as described above. If you apply for and are awarded additional financial aid, you will be automatically enrolled in the four-part payment plan, at an adjusted amount to match your award.

If you drop out of the course after the refund period has ended, you will still be financially responsible for the course fee that you have agreed to pay.

Do you need additional financial aid in order to participate in this course? *

Scholarship is for course tuition only. Mazamas may cover the cost of your course tuition up to 90%. Other costs associated with the course may apply. Please see the course home page for associated costs and logistics. Mazamas will contact you with the status of your scholarship application before course acceptance in order for you to make an informed financial decision about the course. Course leaders will not have knowledge of your scholarship status. Contact Claire Nelson at clairenelson@mazamas.org or 503-227-2345 if you have any questions. 

The Mazamas does not discriminate on the basis of race, gender identity, or sexual orientation. The answers collected below are used to determine scholarship awards and for scholarship tracking purposes. We recognize that members of the BIPOC and LGBTQ communities (among others) may face systemic, structural, and cultural barriers to financial access, and have traditionally been marginalized from outdoor programming. For these reasons, we prioritize members of these groups in determining scholarship awards. However, awards are primarily determined by financial barriers to participation, and the benefit the course can provide to you and your community.

Race/Ethnicity: *
 
Gender: *
 
Do you identify as transgender? *
 
Do you consider yourself a member of the Lesbian, Gay, Bisexual, Transgender and/or Queer (LGBTQ+) community? *
Have you ever applied for a Mazamas Education Scholarship before? *
I understand that this is a pre-registration form and when dates become available I will be sent a link to complete my registration and pay for the course. *