2020 Engineering Camp

    Monday, June 15, 2020 until Thursday, June 18, 2020 Mountain Daylight Time


    Dixie State University Smith Computer Center
    225 S 700 E
    St George, UT 84770
    United States

    Parent/Guardian Information
    Mailing Address




    Participant Information
    Participant's Birthdate
    Emergency Information
    Photo Release
    Participants in DSU events are sometimes photographed and videotaped for use in DSU promotional and educational materials. I authorize DSU to record and photograph my image and/or that of my child for use by DSU or its assignees in research, educational and promotional programs. I understand these audio, video, film and/or print images may be edited, duplicated, distributed, reproduced, broadcast, and/or reformatted in any form and manner without payment of fees.

    I have read and understand the nature of the activity and its inherent risks and I knowingly give consent for participation.
    Parent/Guardian Please Read and Sign the Waiver Release of Liability, Indemnification, and Consent to Medical Attention

    This is a Waiver release of liability, Indemnification, and consent to medical attention. The Informed Consent Form for Minors, identifies risks of participating in DSU course or program, and a Waiver and Release for parents/guardians. Injury may result from your participation in the Mechanical Engineering Camp.

    You are expected to familiarize yourself with what is required, rules of conduct for the course/program as well as DSU policies. You are expected to follow proper operating procedures including safety procedures as outlined by the course/program instructor, plus any directions given by an authorized DSU employee.

    I acknowledge that I have familiarized myself with the Mechanical Engineering Camp and what is required, will follow the rules of conduct, will follow the operating procedures, and will follow any directions given by an authorized school employee. The undersigned, the legal guardian of the student (hereinafter “student”) a student at Dixie State University under eighteen years of age, in consideration of student’s participation in the course/program do hereby agree to this waiver and release.

    I recognize that participation in this trip or activity may involve moderate to strenuous physical activity and may cause physical and or emotional distress to participants. There may also be associated health risks. I state that student is free from any known heart, respiratory or other health problems that could prevent student from safely participating in any of the activities. I certify that I have medical insurance or otherwise agree to be personally responsible for costs of any emergency or other medical care that student receives.

    I agree to release State of Utah, DSU and their agencies, departments, officers, employees, agents, and all sponsors, officials and staff or volunteers from the cost of any medical care that student receives as a result of participation in this course. I further agree to release the State of Utah, DSU, their agencies, departments, officers, employees, agents and all sponsors, officials and staff or volunteers from any and all liability, claims, demands, breach of warranty, negligence, actions, and causes of actions whatsoever for any loss, claim, damage, injury, illness, attorney’s fees or harm of any kind or nature to me arising out of student’s participation in this DSU course/program. This release extends to any claim made by parents or guardians or their assigns arising from or in any way connected with the aforementioned activities. CONSENT Consent is expressly given, in the event of injury, for any emergency aid, anesthesia and / or operation, if in the opinion of the attending physician, such treatment is necessary.

    I have carefully read and understand the contents of the foregoing language and I specifically intend it to cover student’s participation in the above stated activity.

    Camper Expectations
    It is our hope that you and your fellow campers will have an enjoyable camp experience and a safe return home.  You are, therefore, expected to display the following behaviors at all times:
    1. For safety, the directions of camp leaders must be followed at all times, so listen carefully.
    2. Dress should be neat and appropriate for a school setting. Clothing should not display profanity, suggestive slogans, or promote illegal substances.
    3. Swimwear should be modest and appropriate for camp activities.
    4. Closed toe shoes should be worn.
    5. Do not leave your group at any time unless you inform an adult.
    6. Inflammatory comments concerning ability, race, gender, religion, or orientation will not be tolerated.
    7. Do not engage in unsafe behavior in the classrooms or anywhere else on campus.
    8. No visitors will be allowed during the camp experience.
    9. We expect you to treat other campers and staff with dignity and respect at all times.
    10. Treat all campus facilities and equipment with respect and care. It is a privilege to be allowed to use them.
    11. Cell phones are to be turned off during all workshops and other activities. They may be used in an emergency situation.
    If this agreement is violated by a camper, it may result in parents being called and the student asked to leave
    camp.

    I have read, discussed, and understand the expectations. I agree to abide by them for the durations of the
    camp.
    Parent/Guardian
    Participant
    Additional Information
    How did you hear about this program?