Allen Camp Registration Form

MORNING SESSION 9am-12pm

>>STEM - Throughout the week, we will play with physics, explore concepts of bioloby and chemistry, and investigate the world around us! Led by Paul Miller, Travis Robb, and Beth Toland, we will rotate through centers exploring different areas of science to keep our hands working and our brains growing!

>>Art - Create with the amazing Chris Woods! Every day will offer multiple projects to explore different techniques with a wide variety of techniques and materials
>>Games and sports - Spend the afternoon playing games to challenge your mind and physical fittness. We will explore sports and related skills while engaging in novel games focusing on fitness and fun!

Lunch: If you child is enrolled for the full day, then you may send a lunch and your camper will spend the hour between sessions with Allen staff eating, relaxing, and hanging out time with friends.

Payments may be completed online, mailed or delivered to: Allen Community College, Business Office 1801 N. Cottonwood, Iola, KS 66749 Questions? 620-901-6304 or [email protected] Checks should be made out to Allen Community College. Registrations are due May 27th.

***Please read and check below to indicate agreement to these statements.***

TRANSPORTATION AND LIABILITY RELEASE

I understand that my child will be riding in a College van while visiting streams and natural areas around Allen County. I will provide any appropriate car seat necessary for my child to be legally restrained in the College vehicle. I grant permission for my child to use the transportation services of the College for these purposes.

I understand that a student’s use of College transportation is a privilege and is subject to the rules and regulations as determined by College officials. I also understand that transportation privileges may be discontinued at any time for disciplinary reasons.

I hereby release Allen Community College, Iola Industries, and their agents and employees from all claims, demands, and liabilities whatsoever in connection with transportation services provided to my child and the above described activities.

AUTHORIZATION TO PHOTOGRAPH, FILM, OR RECORD STUDENT

I, hereby authorize, release and/or otherwise consent to my child being the subject of photographs, videotapes or audiotapes, webcasts, or combinations thereof, that are taken, shot or recorded at Allen Community College (“College”) or college related activities.

College and/or any of its employees or agents is specifically given the right and permission to cause the above named student’s likeness or voice or both to be recorded and exhibited as still photographs, transparencies, motion pictures, television, video (videotape recordings), webcasts, or other similar media, including other Internet applications.

College and/or any of its employees or agents is specifically given the right and permission to distribute, copyright and/or use, reuse and/or broadcast, rebroadcast, post, publish, and republish still photographs, transparencies, motion pictures, television, video (videotape recordings), webcasts, or other similar media, including other Internet applications.

Both my child and I, if the student is under 18, or I, if the student 18 or older and signing on the student’s own behalf, specifically authorize the reproduction, sale, exhibition, broadcast, posting, and/or distribution of this material without limitation. We further waive any right we may have had to inspect or approve the finished still photograph, transparencies, motion pictures, television, video (videotape recordings), webcast, posting, or other similar media including any sound track associated therewith, or advertising copy or printed matter that may be used in conjunction therewith or the eventual use that may be made of such still photograph, transparencies, motion pictures, television, video (videotape recordings), webcasts, postings, or other similar media, including other Internet applications.


 I have read and agree to the statements above.

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