Cyber Defenders Summer Camp Application Form Instructions
|
|
- Roy Glenn
- 8 years ago
- Views:
Transcription
1 Cyber Defenders Summer Camp Application Form Instructions The Cyber Defenders Summer Camp is put on by the San Antonio College Computer Information Systems Department. It will be an overview of material covered in the Information Technology and Security Academy (ITSA) dual credit program and Cyber Security. A Texas Workforce Commission grant will provide Governor s Summer Merit Program scholarships for qualified participants valued over $240. *Students must be a student in a Texas middle or high school. A recent report card should be included with the application *Students must be ages 14 to 21 on the first day of camp. Birthdate documentation must be provided with application. Valid documents include: Baptismal record, Birth certificate, Driver s license, Passport *Original school and age documentation must be physically shown and copied by the CIS Department Nail Technical Center Room 229 on the San Antonio College campus prior to the first day of camp (preferably at the time of application). Call (210) with questions. Fax completed application to SAC CIS at (210) or Mail completed application to Troy Touchette CIS 1300 San Pedro San Antonio, TX or Hand deliver applications to Nail Technical Center Room 229 on the San Antonio College campus.
2 Cyber Defenders Summer Camp Application Form Student Information Last name First name Middle Gender M F Age Street address City State Zip code Name of your high/middle school* Phone # Date of birth* Ethnicity Hispanic Black (Non-Hispanic) White (Non-Hispanic) Asian/Pacific Islander Native American/Alaskan Native T-Shirt Size: Overall GPA is: Are you interested in a career in IT? Y N Are you a member of an IT-related student club at your school? Y N Are you a Texas foster youth? Y N Please list your top three career choices in the blanks below. Parent/Guardian Information Parent/guardian last name Parent/guardian first name Employer (if applicable) Primary phone # Secondary phone # Primary address Address (if different from what is listed above) Are you the student s emergency contact? Y N Which Cyber Defenders Summer Camp session would your child attend? Aug 4 th -8 th Aug 11 th -15 th If not, what is the name and phone number of the student s emergency contact? Would you require: Early drop off (between 7:30 a.m.-8:45 a.m.) Late pick up (between 4:15 p.m.-5:30 p.m.)
3 Cyber Defenders Summer Camp Application Form Student Essay: In no more than 500 words, tell us why you want to attend the Cyber Defenders Summer Camp and how it will help you achieve your future education and career goals.
4 Cyber Defenders Summer Camp Emergency Form PARENT/GUARDIAN S PERMISSION Student s name: Date of birth: In case of emergency or if San Antonio College must contact me for any reason, I can be reached at (phone #) to be advised of where to pick up my child. If I cannot be reached, please contact (name) at (phone #). If neither party can be reached to make plans for emergency medical care for my child at the time of illness or accident, I give permission for San Antonio College staff to take my child to: Physician name: or Hospital name: Physician phone #: Hospital phone #: Insurance company: Policy number: Please list any of the student s known allergies or significant medical history: Parent/guardian signature: Date:
5 Texas Tort Claims Act TO THE PARENTS OR GUARDIANS OF CAMP PARTICIPANTS: San Antonio College (SAC) is pleased to be able to provide youth in the community with challenging, creative, safe and fun activities during the summer. We strive to make their time with us not only enjoyable, but safe. As parents and guardians of these children, we feel you should be fully informed of the conditions under which your children are visiting our campuses. Under the Texas Tort Claims Act, SAC and the Alamo Community College District are a political subdivision of the State of Texas. Under this Act, the college district is not responsible or liable to any person for property damage, personal injury or death. The only exception to this involves a college district-owned vehicle. Under the Act, the damages the college district may be held responsible for are limited for property damage, personal injury or death caused by a college district-owned vehicle. The Cyber Defenders Summer Camp could include field trips to information technology employers or other college and university campuses. As with the school districts your child attends during the school year, SAC and the Alamo Community College District require a Release and Indemnification Agreement from the parent and guardian of each child. The attached Release and Indemnification Agreement is mandatory for your child s participation in the Cyber Defenders Summer Camp. It gives your permission for your child to participate in any field trips that may take place and to be transported on those trips by college district vehicles and personnel. Signed Releases must be returned prior to the start of the program to allow your child s participation. Please be assured that every effort has been made to provide your child with a healthy, safe environment in which to enjoy this summer program. Should you have any questions, please call the SAC Computer Information Systems (CIS) Department at
6 Release and Indemnification Agreement Form Release and Indemnification Agreement concerning: Student s name: The undersigned representative, on behalf of the child named above (hereinafter the child ), who desires to participate in the Cyber Defenders Summer Camp activity, and in consideration of being permitted to participate in said activity, voluntarily and knowingly executes this release and indemnity agreement on behalf of the child with the express intention of extinguishing the rights and obligations designated herein. Permission is also provided for the child to participate in field trips off campus and for transportation by District personnel and vehicles. As representative of the child, I hereby elect to and assume all risks for claims hereinafter arising, known or unknown, from the conduct of the Kids Camp activity and hereby knowingly and voluntarily expressly release the Alamo Community College District, its employees, agents, representatives, officers, directors or others acting on behalf of Alamo Community College District, from all liability for claims arising out of such matters. With the intention of binding the child and with full authority to do so, I hereby release, discharge and indemnify the Alamo Community College District, its employees, agents, representatives, officers, directors or other acting on behalf of Alamo Community College District, from any and all claims, demands, actions, judgments and executions which the child ever had, or now has, or ever will have, or which the child may claim to have against Alamo Community College District, its employees, agents, representatives, officers, directors or others acting on behalf of the Alamo Community College District, in connection with or arising out of, directly or indirectly, any and all matters relating to the Kids Camp activity, including any alleged acts or negligence by the District s employees, agents, representatives, officers, directors or others acting on behalf of the Alamo Community College District. As the duly authorized agent of the child, I have read this release and indemnification and understand all of its terms. This release and indemnification agreement is executed voluntarily and with full knowledge of its contents and significance. Signature of duly authorized representative for child: Printed name: Date:
7 Acknowledgement of Drop Off and Pick Up Policy I have read and understand the policy and location for dropping off and picking up my child. I understand that San Antonio College and the Computer Information Systems Department cannot be held responsible for my child if she/he is dropped off before 7:30 am. After 5:30 p.m., any child not picked up will be escorted to the SAC D403 Annex, where the parent will pick them up. I understand that it is my responsibility to know what classroom my child is in and where she/he should be dropped off and picked up. I understand the drop-off and pick up times to be the following: 7:30 a.m. Early Drop off 8:45 a.m. Regular Drop off By 4:15 p.m. Regular Pick up By 5:30 p.m. Late Pick up Student s name: Parent/guardian s primary contact number: Parent/guardian s alternate contact number: I DO DO NOT give permission for my child to leave the San Antonio College campus unescorted to either walk home or take public transportation at p.m. Parent/guardian signature: Date: IF YOU HAVE NOT PICKED UP YOUR CHILD BY 5:30 P.M., PLEASE CALL THE SAC COMPUTER INFORMATION SYSTEMS DEPARTMENT AT IMMEDIATELY.
8 Photo/Media Release Form RIGHT OF CONSENT RELEASE WITHOUT COMPENSATION: Individual Consent Form Project Working Title: SAC CIS Cyber Defenders Summer Camp/Summer Merit Program Production Location: San Antonio College Production Date(s): August 2014 Instructor/Dept.: Computer Information Systems I understand that the project mentioned above is being produced and distributed by the Alamo Colleges (referred to as Colleges in this agreement). I also understand that by this release I consent to the use of my likeness and voice, including all related photographs and/or sound recordings, for research, educational, and advertising purposes by the individuals authorized by the Colleges. I also acknowledge that the Alamo Colleges is and will be the sole owner of all rights to such video, photographs, and/or sound recordings of my participation, and I shall not receive compensation for my appearance and voluntary participation in this project. / Signature of participant/ Date If not over 18: I represent that I am the parent/guardian of the above named person. I hereby consent to the foregoing on his/her behalf. / Signature of parent/guardian Date
Aquaculture, Biology, and Conservation Summer Camp 2015 Registration Forms
Aquaculture, Biology, and Conservation Summer Camp 2015 Registration Forms All forms and payment are due no later than June 15, 2015 Note: There is a $25 non-refundable registration fee, and no refunds
More informationTexas A&M University-Corpus Christi Youth Program Medical Emergency Information/Consent for Treatment
Texas A&M University-Corpus Christi Youth Program Medical Emergency Information/Consent for Treatment Youth s name: Address: Date of birth: Parent/guardian phone: Home Work Pager/Cellular Medical Information
More informationHornets Youth Enrichment Summer Program 1200 North DuPont Highway Dover, Delaware 19901 Telephone: 302-857-6824 Fax: 302-857-6823
Hornets Youth Enrichment Summer Program 1200 North DuPont Highway Dover, Delaware 19901 Telephone: 302-857-6824 Fax: 302-857-6823 Participant Last Name: Participant First Name: Grade: Age: Gender: Male
More informationNEW STUDENT REGISTRATION
NEW STUDENT REGISTRATION High Performance: Academy Prep: Early Childhood: $20.00 registration fee (includes 2 Academy T-shirts) $20.00 registration fee (includes 2 Academy T-shirts) $10.00 registration
More informationMath + Leadership Camp at CSUSM Registration Forms
Math + Leadership Camp at CSUSM Registration Forms CONTACT INFORMATION Math for America San Diego Email: sandiego@mathforamerica.org Phone: 858-822-6284 Registration Checklist Complete all sections of
More informationHealthCareers. Discovery Camp. Post Acute Medical Specialty Hospital Corpus Christi, TX June 17 & 18, 2015. Application Packet
HealthCareers Discovery Camp Post Acute Medical Specialty Hospital Corpus Christi, TX June 17 & 18, 2015 Application Packet Personal Information Name: Address: City: State: Date of birth: ZIP code: Home
More informationYALE UNIVERSITY CITIZENS, THINKERS, WRITERS: REFLECTIONS ON CIVIC LIFE APPLICATION FOR SUMMER 2016
NOTE: This application can also be completed online at http://humanities.yale.edu/apply APPLICANT INFORMATION First Name Last Name M.I. Street Address Apt/Unit # City State ZIP Code Student Cell Phone
More informationTRAVELING PHOTOGRAPHY WORKSHOP APPLICATION
Wide Angle Youth Media Presents: TRAVELING PHOTOGRAPHY WORKSHOP APPLICATION WHAT? A free, 4-hour workshop where students will... WHO? WHERE? WHEN? Learn photography skills Take creative self portraits
More informationREADINESS. htp:/apps.bexar.org/electionsearch/electionsearch.aspx?psearchtab=3
READINESS htp:/apps.bexar.org/electionsearch/electionsearch.aspx?psearchtab=3 Family Service Association of San Antonio, Inc. Universal Enrollment Form Before submitting your application, please make sure
More informationAPPENDIX B. Adult Check here if the intern is an adult. Minor Check here if the intern is a minor.
APPENDIX B Adult Check here if the intern is an adult. Minor Check here if the intern is a minor. IMPORTANT: ALL ADULT INTERNS AGREE: [Insert Name] ( Intern ), by my own request, desire to participate
More informationINTERNATIONAL LEADERSHIP OF TEXAS
INTERNATIONAL LEADERSHIP OF TEXAS ACKNOWLEDGMENT OF RISK, INDEMNITY, WAIVER AND RELEASE OF LIABILITY AGREEMENT, NOTICE OF FINANCIAL RESPONSIBILITY, AND MEDICAL AUTHORIZATION & INFORMATION FORM IN WITNESS
More informationYouth Programs Registration Form Summer of Service (SOS) 2015
Youth Programs Registration Form Summer of Service (SOS) 2015 Participant s Information PHONE GENDER: FEMALE OF BIRTH SCHOOL GRADE IN FALL 2015 MALE ETHNIC BACKGROUND AFRICAN ASIAN INDIAN LATINO NATIVE
More informationSan Antonio Tennis Academy
A Six Sigma Standard- The relentless and rigorous pursuit for near perfection 2014 Summer Tennis Camps at San Antonio Christian School Bronze Summer Camp- (ages 8-14 & intro-intermediate High School) 1
More information2014 Fort Worth Regional Science and Engineering Fair, University of Texas at Arlington, RadioShack. Media Release Form
2014 Fort Worth Regional Science and Engineering Fair, University of Texas at Arlington, RadioShack Media Release Form I hereby consent to and authorize the use and reproduction by Fort Worth Regional
More informationBaylor Autism Resource Center Applied Behavior Analysis (ABA) Therapy Program
Baylor Autism Resource Center Applied Behavior Analysis (ABA) Therapy Program Please see the enclosed information and application for more information. The Baylor Autism Resource Center (BARC) Applied
More information2015 Summer Fun Classes Keyboarding on the PC
2015 Summer Fun Classes Keyboarding on the PC All materials are included! Grades 4th 12th Three classes available CRN 95287 - June 15 - June 25 CRN 95288 - July 13 - July 23 Locate home row keys automatically
More informationCompass Road to College Summer Tour Application
Compass Road to College Summer Tour Application Student Information Name: Email Address: Sex: F M Birth Date: Primary Language Spoken at Home: English Spanish Other: Current School: School You ll be Attending
More informationMotorcycle RiderCourse WAIVERS
Motorcycle RiderCourse WAIVERS General Instructions All pages must be completed and signed. If you have any questions, call (231) 591-5819. Mail completed forms to: Motorcycle Rider Courses, Ferris State
More informationSign-up students NOW!
Formally known as SEMAA MAA is a K-12 Hands-on, Minds-on STEM (Science, Technology, Engineering, and Mathematics) engagement at its best! Sign-up students NOW! Tri-C MAA offers fun STEM education activities
More informationCOMMUNITY FOR NEW DIRECTION PARTICIPANT REGISTRATION FORM
COMMUNITY FOR NEW DIRECTION PARTICIPANT REGISTRATION FORM Child s Name (Last) (First) (Middle Init.) Address Apt. # Zip Code Home Telephone Message Telephone Birth Age *Gender: Male Female *Race (please
More informationFOOTBALL CAMPS OF AMERICA, LLC CONSENT FORM
FOOTBALL CAMPS OF AMERICA, LLC CONSENT FORM NOTICE: ALL ATHLETES WILL BE REQUIRED TO HAVE A SIGNED CONSENT FORM BEFORE TAKING THE FIELD. Football Camps of America, LLC. Parental Release Physical Form Waiver
More informationAll Students - Please complete items 1-5 All paperwork must have original signatures and be readable. No partial submissions will be accepted.
Independent Study Physical Education (I.S.P.E.) The following items must be on file before your Independent Study application is complete. (1) Complete the online I.S.P.E. contract (keep a copy for your
More informationDATE OF BIRTH: STREET ADDRESS: CITY/STATE/ZIP:
Get Noticed Beach Volleyball Waiver WAIVER AND RELEASE, EXPRESS ASSUMPTION OF RISK, INDEMNITY AND HOLD HARMLESS AGREEMENT, AND GRANT OF RIGHTS NAME OF PLAYER: PLAYER AGE DATE OF BIRTH: PLAYER GRADE as
More information2015 ADF School Medical/Insurance Information & Liability Waivers INSURANCE INFORMATION
These forms must be completed and signed in all appropriate places by the participant, the participant s physician, and if under age 18, by the participant s legal guardian. The medical information we
More informationKids College 2015. Conducted at Michigan State University July 6-17, 2015. Weekdays from 8:30 11:30 am. Sponsored by:
Kids College 2015 Conducted at Michigan State University July 6-17, 2015 Weekdays from 8:30 11:30 am Sponsored by: This program is partially funded by a grant from: The W.B. and Candace Thoman Foundation.
More informationCTE SUMMER INTERNSHIP PROGRAM
CTE Applications Due: Thursday, May 15, 2014 PROGRAM DESCRIPTION Learn the both the art of culinary as well as how to develop your own business! This summer experience includes a combination of in-class
More informationEnrollment Application 2014-2015
Enrollment Application 2014-2015 Student Name: Date: Current Grade Level: Current School: Date of College Track Presentation: Submit Application by: Checklist of items that must be returned to College
More informationCHICAGO RUNNING TOURS & MORE, LLC WAIVER AND RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT PLEASE REVIEW THOROUGHLY BEFORE SIGNING
CHICAGO RUNNING TOURS & MORE, LLC WAIVER AND RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT PLEASE REVIEW THOROUGHLY BEFORE SIGNING The undersigned, in consideration of being permitted to participate
More informationWELCOME TO YMCA Teen Scene Middle School Enrichment Program (This sheet is for parents to keep for informational purposes)
Robert D. Fowler Family YMCA Middle School Enrichment Program Student Registration Form 2015-16 Ivy Prep Academy Program Hours: 7am-7:45am & 4pm-7pm Transportation AM: Group leaves at 7:30am Transportation
More informationBig House 2015. Cost for the Trip $125 if turned in by March 29th $150 if turned in by April 26th $175 if still space in the camp after April 26th
Cost for the Trip $125 if turned in by March 29th $150 if turned in by April 26th $175 if still space in the camp after April 26th Big House 2015 June 11-14 Bellville, TX Big House is a summer mission
More informationK I D S C A M P 2 0 1 4
K I D S C A M P 2 0 1 4 June 9-12 8 a.m. 4 p.m. Grades 3-12 Fee: $50 Join us for a fun-filled learning experience! For an application packet Please stop by the Ben Hill-Irwin Campus at 667 Perry House
More informationAustin Community College Study Abroad Application Packet Scotland May 2006 APPLICATION COVER PAGE and CHECK LIST
APPLICATION COVER PAGE and CHECK LIST Student Name Program Name: BUSG 1191 International Study Tour Departure Date: May 13, 2006 Return Date: May 21, 2006 Faculty Leaders: Fred Baird Destination Countries:
More informationThe Merritt Kids College Program - A Review
Parent s Name: Address: Email Address: Cell Phone: Emergency Contact Name: Registration Form Home Phone: Number: Child s Name: Grade: Age: School Name: Gender: Male: Female: T-Shirt Size: Small: { } Medium:
More informationLiverpool Football Club International Academy Soccer Schools 2015 Registration Form
Liverpool Football Club International Academy Soccer Schools 2015 Registration Form Day Camp Session Choice: (please check the appropriate box) Day Camp Session 1: Day Camp Session 2: Monday August 3 Friday
More information2016 Bowdoin Summer Art Camp Registration
2016 Bowdoin Summer Art Camp Registration Hours and Location Bowdoin Summer Art Camp will run for four weeks from June 27 th through July 22 th. The times and length of each session vary. Please refer
More informationGeorgia Tech North Ave. NW Atlanta Ga. 30332
Welcome to Fun Weird STEM Saturdays 2014 The functioning objective of Fun Weird Science STEM Saturdays is to: 1. Provide students with hands-on STEM experience; and 2. Engage students in the exciting ways
More informationCommunity House High School Programs Standing with families since 1969
Dear Parents/Guardians, Founded in 1969, Community House is devoted to standing with Princeton families by providing tools for academic success and social- emotional wellness through programs that bolster
More information2016 Summer Camp Registration Form
2016 Summer Camp Registration Form 1 of 6 2016 Summer Camp Registration Form All forms can be found online: http://go.dtcc.edu/swcamps q New Camper q Returning Camper Office Use Only: Identification Number
More informationChild and Youth Group. Volunteer Waiver Form
Child and Youth Group Volunteer Waiver Form VOLUNTEER WAIVER WARNING OF RISK, WAIVER, RELEASE OF ALL CLAIMS AGREEMENT Please read this form carefully and be aware that, in participating, you will be waiving
More informationINSTRUCTIONS FOR COMPLETING REGISTRATION. 2. Fill out the forms completely with necessary information and signatures:
INSTRUCTIONS FOR COMPLETING REGISTRATION 1. Print out the Waiver of Liability, Medical Release Form and Participant Information Sheet attached to this document 2. Fill out the forms completely with necessary
More informationSanta Monica College Administrative Regulation - Students Activities and Student Conduct
Santa Monica College Administrative Regulation - Students Activities and Student Conduct (AR5319-091481) Extracurricular Trips Arrangements for trips by clubs and other non-athletic extracurricular activity
More informationTOWN OF POUGHKEEPSIE POLICE DEPARTMENT
TOWN OF POUGHKEEPSIE POLICE DEPARTMENT INFORMATION PACKET OVERVIEW The Town of Poughkeepsie Police Department is seeking to provide an innovative program for youth residing in the Town of Poughkeepsie.
More information1. COMPLETE & SUBMIT YOUR APPLICATION
Dear Prospective Young At Art Museum Teen Volunteer, YAA Teen Leadership Program Sponsored by American Express Charitable Fund Thank you for your interest in volunteering with Young At Art Museum. The
More informationThank you for your interest in the Illinois Association for College Admission Counseling s 2015 CAMP COLLEGE program!
Greetings! Thank you for your interest in the Illinois Association for College Admission Counseling s 2015 CAMP COLLEGE program! These waiver forms must be completed and submitted in order for your application
More informationUConn First Star Academy 2015 Application Checklist
Student's Name: Social Worker: Area Office: Phone #: UConn First Star Academy 2015 Application Checklist Please use this checklist to make sure the application is complete: 1. Student Application 2. DCF
More information2013 Health Careers Summer Camp Application Checklist
2013 Health Careers Summer Camp Application Checklist Please use this checklist to confirm that all required documents have been obtained and completed before mailing your complete application packet to
More informationPARTICIPANT AGREEMENT RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT
PARTICIPANT AGREEMENT RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT I, the undersigned, on behalf of my minor child: ( Participant ), hereby acknowledge that Participant has
More informationSANTA BARBARA SCHOOL DISTRICTS, SECONDARY EDUCATION INDEPENDENT STUDY PHYSICAL EDUCATION. HOLD HARMLESS AGREEMENT (Agency/Instructor/Coach)
SANTA BARBARA SCHOOL DISTRICTS, SECONDARY EDUCATION INDEPENDENT STUDY PHYSICAL EDUCATION HOLD HARMLESS AGREEMENT (Agency/Instructor/Coach) (Agency/Instructor/Coach) hereby agrees to defend, indemnify and
More informationOberlin Dance Intensive
Oberlin Dance Intensive July 6-11, 2014 For Ages 14-18 Early Registration Deadline: March 1, 2014 = $585 tuition Regular Registration Deadline: April 10, 2014 = $625 tuition Email completed registration
More informationARCADIA YOUTH RODEO ASSOCIATION, INC. 124 Heard Street, Arcadia, Florida 34266 863-494-2014 2015-2016 SEASON MEMBERSHIP APPLICATION
2015-2016 SEASON MEMBERSHIP APPLICATION MEMBER INFORMATION: BACK TAG # ISSUED: MEMBER NAME: ADDRESS: CITY: STATE: ZIP: HOME PHONE: CEL #: E-MAIL ADDRESS: (Please send newsletter via: Mail E-Mail ) DATE
More informationWHEREAS, Participants desire to participate in ALL the recreational activities available at the Trampoline Park; and
THIS PARTICIPATION AGREEMENT is made and effective as of the last date executed (hereinafter the "Effective Date") by and between Get Air Savannah (hereinafter "Get Air") and the adult or guardian identified
More informationRYE AIRFIELD 6 AIRFIELD DRIVE RYE, NEW HAMPSHIRE 03870 WAIVER, RELEASE OF LIABILITY AND INDEMNITY AND HOLD HARMLESS AGREEMENT PARTICIPANT S NAME
RYE AIRFIELD 6 AIRFIELD DRIVE RYE, NEW HAMPSHIRE 03870 WAIVER, RELEASE OF LIABILITY AND INDEMNITY AND HOLD HARMLESS AGREEMENT PARTICIPANT S NAME UNDER 18 YEARS (SIGNED AND INITIALED BY PARTICIPANT AND
More informationRegistration Form Penn State Weather Camp June 14 19, 2015 Penn State Advanced Weather Camp June 21 26, 2015
Registration Form Penn State Weather Camp June 14 19, 2015 Penn State Advanced Weather Camp June 21 26, 2015 TO BE COMPLETED BY PARENT OR LEGAL GUARDIAN. Date of Program Please print in ink or type, and
More informationLATE PAYMENT FEES WITHDRAWAL FROM THE PROGRAM THIRD PARTY (SPLIT) PAYMENTS RESPONSIBLE PARTY. Parent/Guardian Agreement: Dear Parents and Guardians,
Dear Parents and Guardians, In order to simplify and provide better service to everyone, Rancho Simi Recreation and Park District ( the District ) has implemented the following payment processing procedures
More informationWest Virginia University 2015 Forensic Science Summer Camp
Thank you for registering for the! This packet contains the following forms that must be completed and returned before the student will be allowed to attend camp: Participant Information Form Event Participant
More informationPARTICIPANT APPLICATION Page 1 of 3 Revised September 2015
Page of 3 Revised September 05 Student Information Please print in BLACK or BLUE ink. Last Name First Name Middle Name Sex Male of Birth (mm/dd/yyyy) Student School ID # Social Security Number Female Current
More informationCamp Waiver Packet. Student Signature: Date: - - Parent Signature: Date: - - (Parent s signature is required if the student is under the age of 18)
Camp Waiver Packet You should have completed the initial registration and payment process on our website at www.centennialaviationacademy.com prior to completing this packet. If you have not done so, please
More informationIMPORTANT: THIS IS A LEGAL DOCUMENT, PLEASE READ AND UNDERSTAND THIS DOCUMENT BEFORE SIGNING
IMPORTANT: THIS IS A LEGAL DOCUMENT, PLEASE READ AND UNDERSTAND THIS DOCUMENT BEFORE SIGNING. ASSUMPTION OF RISK, WAIVER OF LIABILITY AND INDEMNIFICATION AGREEMENT This agreement (the Agreement ) must
More informationRELEASE OF LIABILITY, INDEMNITY, AND BACKGROUND CHECK AUTHORIZATION AGREEMENT
RELEASE OF LIABILITY, INDEMNITY, AND BACKGROUND CHECK AUTHORIZATION AGREEMENT In consideration, the receipt and sufficiency of which is hereby acknowledged, for being allowed entry into and participation
More informationRelease of Liability. Printed Name of Participant:
Release of Liability IN CONSIDERATION of being given the opportunity to participate in any USRowing activity, including scheduled, supervised club activities, and registered regattas, during the policy
More informationNorth Dakota College Tour
North Dakota College Tour University of North Dakota North Dakota State University Minnesota State University, Moorhead Friday, October 31 - Saturday, November 1, 2014 Open to Sophomores, Juniors, and
More informationPROGRAM APPLICATION FOR GATEWAY TO COLLEGE ADMISSION
PROGRAM APPLICATION FOR GATEWAY TO COLLEGE ADMISSION Please read the entire application carefully before completing. Print clearly. Use a black or blue ink pen. Only complete applications will be considered.
More informationEmerald Hills Junior Golf Camp - Summer 2016. 938 WILMINGTON WAY REDWOOD CITY, CA 94062 www.playemeraldhills.com E-Mail - jrgolf.ehgc@gmail.
OUR CAMPS ARE FOR GIRLS AND BOYS (AGES 5 THRU 14) Visit our website at Junior Golf Camp (9:00am 12:30pm) We start camp early (8:45am) on Monday for check-in and orientation. The camp is designed for beginners
More information7 th Annual CHICAGO JAZZ PHILHARMONIC
7 th Annual CHICAGO JAZZ PHILHARMONIC Dear Students and Parents: Welcome to the 7 th Annual CJP Jazz Academy. We have an exciting jazz program lined up for the 2 weeks you will be part of our family. Chicago
More informationTxSWANA. Houston, Texas. June 26 th and 27 th. Registration Packet. Sponsored by the City of Houston and Republic Services
2015 TxSWANA ROAD-E-O Houston, Texas June 26 th and 27 th Registration Packet Sponsored by the City of Houston and Republic Services 2015 TxSWANA Lone Star Chapter Road-E-O WAIVER OF LIABALITY AND RELEASE
More informationVIVA! Peer Tutors 2012 Health Literacy Video Contest COPYRIGHT FORM
COPYRIGHT FORM Every entrant must complete and submit this form together with ALL OTHER FORMS. Please do not send separately. All forms must be received by March 19, 2012. Please complete this form and
More informationStudent Board of Directors Application Packet
Dear Student, Thank you for your interest in participating in the Student Board of Directors Program at the Federal Reserve Bank of Kansas City, Denver Branch. Please complete this application packet,
More informationRegistration Form Spots are limited and on a first come first serve basis
UT Houston Medical School s JAMP Symposium March 27 th or April 17 th, 2015 Registration Form Spots are limited and on a first come first serve basis Please Note: Registration is not complete until you
More informationMontefiore s Health Opportunities Program (Monte-HOP) Summer Internship Program Application Deadline: April 17, 2015
Montefiore s Health Opportunities Program (Monte-HOP) Summer Internship Program Application Deadline: April 17, 2015 Please read application package in its entirety. Program Description: The Montefiore
More informationMINORS ON CAMPUS. 1. Supervision, Background Investigations, Compliance with Laws and Rules:
MINORS ON CAMPUS Required Provisions in Affiliation Agreements/Contracts [Appendix D] 1. Supervision, Background Investigations, Compliance with Laws and Rules: (A) Licensee shall, at licensee s sole cost
More informationGIRLS SOAR! AVIATION DAY CAMP
GIRLS SOAR! AVIATION DAY CAMP Saturday, March 19, 2016 9:00am 3:00 pm American Airlines C.R. Smith Museum $25 Member/ $35 Non-Member Registration Take off with us at our 1 st Girls Soar Aviation Day Camp!
More informationCamp Culinaire. Camp Dates June 22-24, 2016 12:30 5:30 p.m. each day
Camp Culinaire Camp Dates June 22-24, 2016 12:30 5:30 p.m. each day For more information contact Jessica Hoffman Email: jhoffman16@ivytech.edu or Phone: 317-921-4292 Ivy Tech Community College Central
More informationGRANTS PASS SCHOOL DISTRICT INDEPENDENT CONTRACTOR AGREEMENT DATE: 9 /8 /2015
GRANTS PASS SCHOOL DISTRICT INDEPENDENT CONTRACTOR AGREEMENT DATE: 9 /8 /2015 SECTION 1. IDENTITY OF INDEPENDENT CONTRACTOR This Agreement is between Grants Pass School District Number 7 (hereinafter District
More informationTexas 4-H Member Enrollment Form 4-H Year: 2014-2015
Texas 4-H Member Enrollment Form 4-H Year: 2014-2015 qpostal Mail qemail Name (Last, First) County Family Email Correspondence Preference Member Email Middle Name Preferred Name City Zip Code Parent/Guardian
More informationSOUTHWEST OHIO INLINE HOCKEY PLAYER DOCUMENTATION COVERSHEET
SOUTHWEST OHIO INLINE HOCKEY PLAYER DOCUMENTATION COVERSHEET School / Team: Name: Address: City, State, Zip: Home Phone: Cell Phone: Email: (please circle your responses) Do you attend the above named
More informationYMCA OF GREATER NEW YORK SUMMER CAMP REGISTRATION FORM
YMCA OF GREATER NEW YORK SUMMER CAMP REGISTRATION FORM Branch: North Brooklyn YMCA Camp Site: North Brooklyn Branch Camp Type: PARTICIPANT INFO Child s Name Age D.O.B. Gender Grade in September 2016 School
More informationInitial. Registration Packet. Summer Academy June 3 rd to August 30 th Z M G. www.zmgtennis.com. HP and TTT Registration Form 1 ZMG Tennis, LLC
Registration Packet Summer Academy June 3 rd to August 30 th Z M G www.zmgtennis.com HP and TTT Registration Form 1, LLC Enrolment Process prides its self on offering everything essential in the development
More informationwithout a signed waiver Santa Fe, NM 87506 Fax: 505 820 Student Name: City: Zip: State: Physician's Name: Parent Name(s): Parent Address: City:
Please mail application to: Las Campanas Compadres, Inc. 15 Buckskin Circle Santa Fe, NM 87506 Fax: 505 820 2709 Las Campanas Compadres, Inc. Student Application Form Please be sure to sign the waiver
More informationJune 4, 2015. Dear Parents,
June 4, 2015 Dear Parents, We are excited to offer a special opportunity for your students for the 2015-2016 school year from the Vetri Foundation and the Free Library of Philadelphia. The Free Library
More informationHow To Volunteer With The City Of Chicago Animal Control
City of Chicago Rahm Emanuel, Mayor Department of Animal Care & Control NOTICE OF VOLUNTEER OPPORTUNITY NOTICE OF VOLUNTEER OPPORTUNITY Animal Care & Control - UNPAID The Department of Animal Care & Control
More informationRegistration 2012 Summer (Available 7am - 6pm) Child s Full Name: Name Used: Date of Birth: Gender: Grade: Full Address:
ZION CHRISTIAN CHILDREN S CENTER SCHOOL AGE SUMMER CAMP Zion United Methodist Church ~ 1674 Zion Road Troy, VA 22974 (434) 906-5494 ~ ZionUMCAfterschool@gmail.com Registration 2012 Summer (Available 7am
More informationGUATEMALA SURGERY TRIP Youth Volunteer Information and Release Form
Team Name: Guatemala Surgery Travel Dates GUATEMALA SURGERY TRIP Youth Volunteer Information and Release Form Please complete this entire form, including the release and liability form and return immediately.
More informationRowan University s Aim High Science and Technology Academy
s Aim High Science and Technology Academy (residential) Summer Science and Technology Program for Rising Seniors (Current 11th Graders) July 5, 2015 - July 31, 2015 (Sunday-Friday) STUDENT APPLICATION
More informationCONTRACT. Southwest Tour. Arkansas and Texas
27 th Annual Tour CONTRACT Southwest Tour Arkansas and Texas APRIL 3 rd April 10, 2016 COLLEGES and UNIVERSITIES (Tentative) Arkansas Baptist College, Huston-Tillotson University, Jarvis Christian College,
More informationWilderness First Aid. Basler Center for Physical Activitiy. Saturday Feb. 25 - Sunday Feb. 26. Non Credit Instruction. Wilderness First Aid
Non Credit Instruction Saturday Feb. 25 - Sunday Feb. 26 Wilderness First Aid Offered at ETSU through Landmark Learning. Saturday Feb. 25 through Sunday Feb. 26 8 a.m 5 p.m. Wilderness First Aid $125 ETSU
More informationYouth Camp Civic Center
Youth Camp Civic Center Household ID # Please circle the session(s) that your child(ren) will attend Session One June 8- June 12 Session Two June 15 June 19 Session Three June 22 June 26 Session Four June
More informationElk Grove Park District Preschool Date
Class For Office Use Only New/Readmit Birth Cert. In/Out of Dist Release Medical Elk Grove Park District Preschool Date Name of Child M F Date of Birth Age Primary Phone # Address City Zip Primary e-mail:
More informationCAMP MSC SENSATIONAL SUMMER SCIENCE
CAMP MSC SENSATIONAL SUMMER SCIENCE Thank you for choosing Camp MSC for your summer camp experience. Our camp programs are designed to be engaging, hands-on, challenging, and of course, fun! All full day
More informationAmnesty International - Requirements For 2015 Regional Conferences
Amnesty International USA sponsors special enrichment events for youth leaders as a means of providing a comprehensive and diverse learning environment to further their understanding of and participation
More informationSTUDENT APPLICATION FORM 2015
Camp Information: STUDENT APPLICATION FORM 2015 July 5 - July 10 and July 12 - July 17, 2015 Engineering Your Place in Space The ExxonMobil Bernard Harris Summer Science Camp (EMBHSSC) is organized to
More informationACAP. Student Application Package. Summer Career Residency Program at University of Illinois at Chicago July 15-19, 2012
ACAP Accounting Career Awareness Program Student Application Package Summer Career Residency Program at University of Illinois at Chicago July 15-19, 2012 A program of the National Association of Black
More informationUNIVERSITY OF HOUSTON
JAMES DICKEY'S UNIVERSITY OF HOUSTON 2014 MEN'S BASKETBALL CAMPS CAMP FEATURES Expert instruction from Houston Basketball staff and student-athletes Outstanding lectures Grouping of all players by ages
More informationWelding and Fabricating Training Program
This is the enrollment agreement for the ALLWEST Welding and Fabricating Training program. Please complete this agreement and return it to the administrative offices at: 12928 E. Indiana Avenue, Suite
More informationFUN IN THE SUN SUMMER DAY CAMP BEHAVIORAL CONTRACT
FUN IN THE SUN SUMMER DAY CAMP BEHAVIORAL CONTRACT This contract is to be signed by both the participant (child) and his or her parent/guardian. This ensures that both the child and the adult understand
More informationWinter Camp 2015 Church Registration Instructions and Policies
Winter Camp 2015 Church Registration Instructions and Policies Registration Instructions: 1) Choose your weekend(s). Prayerfully consider which available weekend is the best for your church. Bring your
More informationKarate Adventure Summer Camp
Karate Adventure Summer Camp Our Summer Karate Camp is one of the most unique summer camps available to children. It provides an enriching selection of self defense activities as well as many fun summer
More informationExploring Math and Science Academy (EMSA)
Student Name: 1 THE UNIVERSITY OF OKLAHOMA HEALTH SCIENCES CENTER (OUHSC) OFFICE OF COMMUNITY PARTNERSHIPS AND HEALTH POLICY A primary goal of the University of Oklahoma Health Sciences Center (OUHSC)
More informationTravel Grant Application Fall 2015 October 23 Deadline
Travel Grant Application Fall 2015 October 23 Deadline The USUAA Student Travel Scholarship program was created by USUAA Student Government and is funded entirely by student fees. Scholarships are awarded
More informationCitizens Academy Overview
If you reside, own property, or a own a business in the City of Sarasota, you are invited to apply for the Citizens Academy by downloading an application which is available on the Neighborhood and Development
More informationThis registration form is also accessible online at: https://www.csuohio.edu/business/gyes-2015
STUDENT REGISTRATION FORM Camp Session Dates: June 22, 2015- June 26, 2015 This registration form is also accessible online at: https://www.csuohio.edu/business/gyes-2015 Last Name: First Name: M.I.: Preferred
More information