KU School of Engineering High School Summer Camp

   

Section 1: Participant Form

Camper Information
(Street, PO Box, City, State, Zip)
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Parent's/Guardian's information
(Street, PO Box, City, State, Zip)
(Street, PO Box, City, State, Zip)
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Emergency Contact Information: (Other than Parent/Guardian)
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Physical, Dietary, Or Medical Restrictions

Participant Guidelines/expectations

Camp Activities: Participants are required to attend and participate in all camp academic sessions, laboratories and activities. In addition, all sessions, activities, and experiments will take place under the supervision of camp personnel. Full participation is the only way a participant can gain real value from the camp.

Mobile Device/Internet Usage: Program participants will refrain from using electronic devices (mobile phones, tablets, computers, etc.) during instructional periods unless authorized by program staff. Program participants should not abuse internet privileges. Attempting to access unauthorized sites is strictly prohibited.

Leaving Campus: Program participants are to remain on campus for the duration of the program unless program activities require otherwise. If a participant needs to leave campus for some reason, the Program Director must receive prior written permission from the parent or guardian, and grant specific information. Camp personnel will provide all necessary transportation; therefore personal vehicle usage is not permitted. It is preferred that camp participants be brought to campus by a parent or guardian; however, if a camper must bring a personal vehicle to campus, the keys will be turned into the camp director at check-in and returned at the end of the camp. Program participants must abide by all parking rules and regulations. KU is not responsible for damage to vehicles or for any parking tickets, fines, or towing charges that result from violations.

Use of Alcohol, Tobacco and/or any Illegal Substance: The University of Kansas prohibit the use of alcohol and other illegal substances. Program participants may not possess, use, distribute, or sell alcoholic beverages, drugs, firearms, weapons or fireworks. In accordance with state law, smoking is prohibited by anyone under the age of 18. Smoking is not permitted in any buildings on the University of Kansas campus. Any camper caught with any such items will immediately be reported to campus police and sent home from the camp.

Medical: Participants shall handle any arrangements for the use of prescription medications and/or procedures (i.e. allergy pills, insulin injections, etc.) directly through Watkins Health Center. KU Summer Engineering Camp: Project Discovery personnel cannot and shall not administer any medications to participants (including ibuprofen or any other over-the-counter medicine). Participants shall not be in possession of, or under the influence of, a controlled substance except as administered by Watkins Health Center or by a private physician. Watkins does not accept Medicare or Medicaid.

Residence Hall: Program participants will abide by nightly curfew and “lights out” announcements from the Program Director and Camp Staff. Participants must be in their own room at lights out and remain there until morning. Any use of cell phones or other electronic devises is prohibited after “Lights Out”. All furniture must remain unchanged and kept in place. Coed visitation in KU Housing is permitted in common areas only. The only people permitted in rooms are program staff, members of the participant’s immediate family, the participant’s roommate/s and other program participants of the same gender. Program participants should keep their rooms locked at all times even if leaving for only a few minutes. The University of Kansas, nor program staff is responsible for lost or stolen items. Leave excess money and valuables at home. Valuables, including jewelry, iPods, cell phones, etc. may be brought, but only at participant’s own risk.

Vandalism: Program participants found tampering with any fire equipment (fire alarms, smoke detectors, fire extinguishers, etc.) will be dismissed from the program immediately. Participants may not interfere with any security system or tamper with locks in buildings, other participant rooms and other areas. Vandalism and pranks will not be permitted. Any damages caused to university property (classrooms, labs, housing, common areas, etc.) will be charged to the responsible party. Replacement cost will be charged to anyone who removes or damages university property.

Dismissal: Participants shall follow all procedures as outlined in this document and must abide by rules and guidelines set by the program instructors for each activity and facility in use. If at any time during the camp a camp staff member determines that the behavior of the participant creates a safety hazard, is not in accordance with the rules and/or is a disturbance to other campers, the camper will immediately be sent the home from the camp.

Cancellation & Refund Policy: No refunds will be given for cancellations less than 5 days before camp begins. To request a refund please email engrcamps@ku.edu.

Consent to Participate/Release of Liability: We/I understand that participants will be instructed on proper procedures and use of laboratory equipment and will be expected to follow proper procedures. We/I have read the requirements of participating in the program and give our/my consent to have the participant engage in the activities of the program. In consideration of the University of Kansas allowing participants’ attendance in the program, we/I release the University of Kansas and its employees from any and all claims of injury, damage or liability resulting from participation in camp activities.

Please sign below to signify full understanding of the rules discussed above.

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Release From Liability Agreement

As the parent or guardian, I have the authority to make legal decisions for the benefit of my child.

In consideration of my child’s/ward’s participation in the KU School of Engineering High School Summer Camp activities on the University of Kansas campus, I hereby release, forever discharge, and hold harmless the Kansas Board of Regents, the University of Kansas, and all of their respective employees, agents, officers and contractors from liability for any and all losses, damages, injuries, claims, demands, lawsuits, expenses and any other liability of any kinds, to me, my child/ward, or any other person, arising out of or in connection with my child’s ward’s participation in, attendance at, and/or travel to and from the KU Summer Engineering Camp: Project Discovery.

I understand that the terms of this Release are subject to and shall be governed by and construed in accordance with the laws of the State of Kansas. This Release shall bind the signor, his/her heirs, next of kin, executors, administrators, successors, or assigns and shall inure to the benefit of the parties released, their heirs, next of kin, executors, administrators, successors or assigns.

IN SIGNING THIS RELEASE, I ACKNOWLEDE AND REPRESENT that I have read the foregoing Release, understand all of its provisions, and sign it voluntarily. I warrant that no oral representations, statements, or inducements relating to this Release have been made. I acknowledge that I have had the opportunity to review this document and to seek legal advice if I have any questions.

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Photo, Video, Audio, And Information Release

I, the undersigned, hereby consent to allow my child/ward to be photographed and/or voice to be recorded as part of the KU Summer Engineering Camp: Project Discovery. I hereby grant to the University of Kansas the rights to use my child’s/ward’s image, voice, name and/or likeness in any medium whatsoever for the purpose of promoting the University of Kansas or any of its units, without any payment to me. I hereby expressly waive any rights of action I may have and release the Kansas Board of Regents, the University of Kansas, and all of their respective employees, agents, officers and contractors from liability arising out of or in connection with the use of such image, voice, name and/or likeness, including, but not limited to any claims for any violation of any personal or proprietary right.

The University, its successors and assigns shall own all rights, title and interest, including without limitation the copyright, to any such photograph, video-recording and/or audio-recording.

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Acknowledgement And Release Personal Use Of Disclosed Medications

This will allow your child to self-administer any approved medication, such as allergy meds. This includes over-the-counter medications, such as ibuprofen and acetaminophen.

Section 2: Health Form

Youth Program Participant's Health Form

This completed form must accompany the individual on first visit to Watkins Health Services (WHS). It is essential that the Treatment Agreement is signed by a parent or guardian.

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Emergency Contact, if other than above
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Medications and their dosages taken by the youth

Immunization History – Please provide dates for the following OR provide a copy of an Official Immunization Record

(should be updated no longer than every 10 years)

   

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