Engaging Students in Contemporary Issues and Civic Action Through Art

youTHink COLLEGE CAMP for rising 12th graders

The application for College camp involves two steps, both due Thursday, June 6th: 1. Please complete the application at http:// http://yTcollegecamp12.eventbrite.com 2. Please complete and sign this participation contract with a parent or guardian and return to:
Mail: youTHink 6505 Wilshire Blvd. #100 Los Angeles, CA 90048 ATTN: Tasha Johnson Fax: (323) 761-8990 Email: Tasha@youthink.org

Participation Contract: I am applying to participate in the youTHink College Camp- June 11-13, 2013. At Marymount College 30800 Palos Verdes Drive East Rancho Palos Verdes, CA 90275 My parent/ guardian and I understand and agree to the following: We understand that the camp is 3 sessions long and that I must attend all the sessions to participate. We understand that transportation will be provided, if requested. We also understand that if we are running late or will not be at the shuttle stop, we need to contact Tasha Johnson at (703) 725-8349 as soon as possible. Although we are not being charged to participate in this camp, we understand that youTHink College Camp is valued at $400/ student. We also understand that there are limited openings in this camp, so we agree to call Tasha at (703) 725-8349 IMMEDIATELY, if I (student) become unable to attend, so another student can be offered the opportunity. I (parent/guardian) give permission for photos/video of my child taken while participating in youTHink programs to be used in promotional materials for youTHink and the Zimmer Childrens Museum, which may include an institutional video, website, or brochures.

I understand that transportation will be by:

Shuttle / Car

I understand that adequate and appropriate supervision will be provided. I recognize, however, that unanticipated situations and problems can arise on any trip, which A program of the Zimmer Childrens Museum 6505 Wilshire Boulevard #100 Los Angeles, CA 90048 Phone: (323) 761-8911 Fax: (323) 761-8990 www.youthink.org

situations or problems are not reasonably within the control of the supervising youTHink and/or Zimmer Childrens Museum staff (including volunteers). In such instances, I agree that the Zimmer Childrens Museum and the supervising youTHink and/or Zimmer Childrens Museum staff (including volunteers) are not to be held legally responsible in the event of accident or injury and I will hold the Zimmer Childrens Museum and the supervising youTHink and/or Zimmer Childrens Museum staff (including volunteers) harmless from any costs, liability, or related expenses.

I give permission for emergency medical attention to be administered should that be necessary while on this fieldtrip. I also give my permission for photos of my child taken while participating in youTHink programs to be used in promotional materials for youTHink and the Zimmer Childrens Museum, which may include an institutional video, website, or brochures.
Emergency Contact Information: During the fieldtrip, I can be reached at:

If unable to contact parent/ guardian, in case of emergency, please call: (name, relationship and phone number)

__________________________ PRINT Student Name __________________________ Student Signature and Date

_______________________________ PRINT Parent/Guardian Name _______________________________ Parent/Guardian Signature and Date

A program of the Zimmer Childrens Museum 6505 Wilshire Boulevard #100 Los Angeles, CA 90048 Phone: (323) 761-8911 Fax: (323) 761-8990 www.youthink.org