Transportation Careers Camp

Transportation Careers Camp Registration Form

Minnesota North College- Hibbing
Free summer camp for students in grades 9-12 interested in learning about careers in transportation! Camp runs August 22, 2024, 9:00 AM- 4:00 PM. Registration requires the signature of the student's parent or guardian. Students may not register without permission of parent or guardian. Registration is due by July 31, 2024.

Make sure to dress appropriately. Pants (Jeans preferred/no shorts) and closed toe shoes required (no sandals or crocks). Safety glasses and ear plugs will be provided when needed.
Student's Information
Student's Name*
Nickname
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Preference of Communication
Gender*
Preferred Pronouns
How would you best describe yourself (student) ?*
Are you Hispanic or Latino ( a person of Cuban, Mexican, Puerto Rican, South or Central America or other Spanish culture, regardless of race)? (Optional)
Date of Birth*

MonthDayYear
Date
Student's Age
NOTE - Children need to have entering 9-12th grade.
Entering Grade in 2024/25*
School Student Attends*
County Student resides in?
Can student attend camp both days? August 22, 2024, 9:00 AM - 4:00 PM and August 23,2024, 9:00 Am -2:00 PM.*

Emergency Contacts

Emergency Contact #1
Full Name*

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary Phone Number*
Secondary Phone Number
Relationship to Child*

Medical / Health Information
Does your child have any allergies? Check all that apply*

FoodMedicationEnvironmentalNone
Please list and explain any allergies. Put NA if no allergies.*

0/150
Does your child have a special health or medical condition we should be aware of?*
Please explain. If no allergies, write NA.*

0/150
Does your child have any dietary restrictions, including those for medical, religious, or cultural reasons? *
Please explain. If none, write NA.*

0/150

To be signed by participants in the Transportation Summer Camp; as part of Student Activities at Minnesota North College.

I have voluntarily agreed to participate in the Transportation Summer Camp. I am not required to participate in the Transportation Summer Camp.

The camp consists of hands on activities. Activities include, but are not limited to: Automotive and Diesel Mechanics. I am aware of the dangers and risks to my person and property involved in participating in these activities. Risks associated with my participation in the Transportation Summer Camp include, but are not limited to, loss of or damage to personal property, bodily injury, or even death. All such risks are known, understood, and assumed by me.

In consideration of the Minnesota North College’s agreement to permit me to participate in this activity, the receipt and sufficiency of which is hereby acknowledged, I agree as follows: I agree to abide by the safety rules and regulations as set by the camp leads and Minnesota North College. Failure to do so will disqualify me from participation.

I, individually, and on behalf of my heirs, successors, assigns and personal representatives, hereby release and forever discharge the College/University, the State of Minnesota, and its employees, agents, officers, trustees, and representatives (in their official and individual capacities) (“Releasees”) from any and all liability whatsoever for any and all damages, losses or injuries (including death) I sustain to my person or property or both, including but not limited to any claims, demands, actions, causes of action, judgements, damages, expenses and costs, including attorney fees, which arise out of, result from, occur during, or are connected in any manner with my participation in the Transportation Summer Camp whether caused by the negligence of the Releasees or otherwise; except that which is the result of gross negligence and/or wanton misconduct by the Releasees.

I, individually, and on behalf of my heirs, successors, assigns and personal representatives, hereby agree to indemnify, defend and hold harmless the College/University, the State of Minnesota, and its employees, agents, officers, trustees and representatives (in their official and individual capacities) from any and all liability, loss, damage or expense, including attorney fees, that they or any of them incur or sustain as a result of any claims, demands, actions, causes of action, damages, judgements, costs or expenses, including attorney’s fees, which arise out of, occur during, or are in any way connected with my participation in the Transportation Summer Camp.

I hereby consent to receive medical treatment that may be deemed advisable in the event of injury, accident or illness during this activity or event.

I agree that this Waiver, Release and Indemnification Agreement is to be construed under the laws of the State of Minnesota, U.S.A.; and that if any portion is held invalid, the balance shall, notwithstanding, continue in full legal force and effect. I agree that this Agreement is to be construed broadly to provide a release, indemnification and waiver to the maximum extent permissible under applicable law.

In signing this document I hereby acknowledge that I have read this entire document, that I understand its terms, that I am at lease eighteen (18) years of age, that by signing it I am giving up substantial legal rights I might otherwise have, and that I have signed it knowingly and voluntarily.
I,_______________ , am the parent or legal guardian of the participant who has signed above. I have read and I understand the provisions of this document, I consent to the participant taking part in the activities described above, and I fully enter into and agree to the above Waiver of Liability, Release, and Indemnification Agreement. Parent or guardian Signature

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Photographs or video may be taken by Minnesota North College including photographs of your child(ren). Some of these photographs may be used in printed materials and/or on our official website or our sponsored social-media website on the internet to promote future events sponsored by Minnesota North College. In the event a photograph or video is used for these purposes, every effort will be made to protect the individual identity of all individuals depicted in the picture or video. No names, telephone numbers, addresses or other identifying information will be placed in the printed materials or on the internet. For these reasons, we are asking for your permission to use your/your child's photographs in our materials and on our website. By signing, I hereby grant Minnesota North College permission to use photographs, video and/or other images of my child(ren) for the purposes outlined above.
I, _______________, am the parent or legal guardian of the participant who has signed above. I have read and I understand the provisions of this document, I consent to the participant taking part in the activities described above, and I fully enter into and agree to the above Photography Waiver. Parent or guardian Signature

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Transportation Careers Camp Registration Form

Student's Information

Emergency Contacts

Medical / Health Information