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(be sure essay is typed, double spaced, 12 point font and no abbreviation)
Letter of recommendation from your high school.
Letter of recommendation from your church and/ or community leader.
One page essay- no more than 500 words or one page, 12 point font, double spaced.
Completed Application for consideration.
1. I will respect ALL chaperones, bus drivers, students, and representatives at the schools and other locations we will be attending AT ALL TIMES.
2. I will be on the bus at the required time.
3. I will NOT fight, curse or have an inappropriate.
4. I will NOT run or horseplay in the hotels.
5. I will respect my roommates and their property.
6. I will NOT leave the hotel without permission for the chaperones.
7. I understand that I am not able leave with family members or friends, from other cities, but they are able to visit me at the hotel during appropriate times.
8. I will dress respectfully and appropriately during college visits and sites/attractions.
9. I will attend all gatherings and be fully attentive during all aspects of the tour.
10. I will abide by social media guidelines.
11. I will NOT use headphones, hands free devices or listen to music during presentations. I realize that if I do, my property will be taken away until the end of the activity.
12. I will NOT snack during actual tours. I understand that doing so is considered disrespectful and thus, against the rules set forth by Waukegan Township and Partners.
By checking you agree and acknowledge your electronic signature is valid and binding in the same.
By checking as a witness you are confirming that the Parent/Legal Guardian has agreed and acknowledged the information above.
I consent to this Photo Release Form. I grant Waukegan Township, its volunteers, employees, agents, representatives, and licensees permission to copy, edit, publish and otherwise use my name, image and likeness, with or without my name. This includes marketing purposes or for any other lawful purpose, in any publication and in any medium, including, by way of example and not limitation, posting a photo of me from the tour/meeting on a social media, web site, (collectively, “Reproduction”) without compensation.
I assign to Waukegan Township all right, title and interest in and to all such Reproductions as well as the unencumbered right to exercise such rights in all media and by any means now known or hereafter created, throughout the world, in perpetuity.
I hereby hold harmless and release and forever discharge Waukegan Township and its volunteers, employees, agents, representatives, and licensees, from all claims, demands, and causes of action which I or the undersigned or any respective heirs, executors, administrators or assigns have or may have resulting by reason of this Photo Release Form.
I HAVE READ THIS PHOTO RELEASE FORM BEFORE SIGNING BELOW AND I FULLY UNDERSTAND THE CONTENTS, MEANING, AND IMPACT OF THIS PHOTO RELEASE FORM:
Dates: March 22-29, 2020
This form MUST be completed and accompany completed application packet. ALL information should be read thoroughly, completed and signed by parent or responsible party.
EMERGENCY CONTACT INFORMATION
(In addition to the Medical Consent Information form):
During the above reference time frame, I can be contacted at the following phone numbers:
I acknowledge that I am the parent or legal guardian of the student referenced above and give permission for my child to attend the 2020 Artis Yancey HBCU Tour presented by Waukegan Township & Partners. I understand that in the event my child does not exhibit the expected behavior, I will be contacted and depending on the severity of his/her infractions, I will be financially responsible for securing transportation returning them home.
I have read this document, and I am signing it freely. I understand the legal consequences of signing this document, including (a) releasing the Township from all liability on my and the Participant’s behalf, (b) waiving my and the Participants’ right to sue the Township, (c) and assuming all risks of Participant’s participation in this Activity. I understand that I am responsible for the obligations and acts of the Participant as described in this document. I agree to be bound by the terms of this document.
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