DAUPHIN COUNTY TECHNICAL SCHOOL 6001 Locust Lane, Harrisburg, PA (717) ext * Fax: (717)

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1 SUMMER CAREER CAMP 2014 March 2014 Dear Parent or Guardian, Dauphin County Technical School is once again offering Summer Career Camp. This camp is free to all current 6 th and 7 th graders from Dauphin County public schools. Students from consortium districts (Central Dauphin, Derry Township, Halifax, Lower Dauphin, Middletown Area, and Susquehanna Township) will have priority over non-consortium applicants provided deadlines are met. Goal: To conduct a career exploration camp that is free, fun, educational, and safe. DCTS instructors are preparing fun activities to introduce your child to a variety of different career options. Your child will have the opportunity to meet many of our academic teachers and experience several career and technical programs, including: Automotive Technology Building Construction Technology Carpentry Collision & Refinishing Technology (tentative) Drafting & Design Technology Electrical Construction & Maintenance Electronics Technology Law Enforcement Masonry Outdoor Power Equipment Ornamental Horticulture Precision Metals (tentative) s: June 16 th, 17 th, 18 th, 2014 Times: Monday & Tuesday: 8:30am 3:00pm Wednesday: 8:30am 1:30pm Note: Breakfast and lunch will be provided to students all three days. Location: Dauphin County Technical School Registration: Complete the attached registration and release forms and return them no later than Friday, May 16, 2014 to: Christine Noll, Vocational Transition Counselor Dauphin County Technical School, fax: Special Note: On Wednesday, June 18th, at 11:30 am, parents are invited to have lunch with their camper (on us!) and view a special presentation of the week s activities. Please RSVP on the registration form. All campers will be provided breakfast and lunch, and any camper projects will be sent home. For additional information contact: Christine Noll at: ext Space is limited, so register early Registration confirmations will be mailed by Friday, May 30, 2014

2 DCTS CAREER CAMP PARTICIPANT REGISTRATION and EMERGENCY INFORMATION FORM This is to certify that has my permission to participate in Career Camp at Dauphin County Technical School on Monday, June 16 through Wednesday, June 18, I/we do hereby absolve and release school officials or other responsible adults from claims for personal injuries or illness, which might be sustained while he/she is traveling to, from, or during the Career Camp activity. I/we authorize a DCTS representative to take to a physician or emergency room of a hospital, and I/we will incur expenses for necessary services and realize payment of these costs is my/our responsibility. I acknowledge that while DCTS will make every effort to minimize exposure to known risks, all stresses and hazards associated with hands on activities cannot be foreseen. has a personal responsibility to follow established safety rules and procedures, including wearing closed toe shoes (sneakers), and will make the group leader aware at any point in which the ability to participate in any activity is in question. (Guardian) will be responsible for following the established schedule, abiding by all state laws and DCTS policies, and acting in a responsible manner suitable to represent DCTS during the Career Camp experience. M F Student s Name of Birth Gender Parent s/guardian s Name (print) ( ) ( ) ( ) ( ) Home Phone Work Phone Cell Phone Alternate Phone City, State, ZIP Code Home School District / Current Grade Student s T-shirt Size S M L XL XXL I understand that breakfast and lunch are provided free of charge to my son/daughter. I will will not attend the luncheon and presentation on Wednesday, June 18 th at 11:30 am. Number of parents attending (circle one) 1 or 2 Number of siblings attending *We ask that only 2 adult parent/guardians attend the luncheon. Siblings may attend as well.

3 Emergency Contact and Medical Information for a Child M F Child s Name of Birth Gender Parent s/guardian s Name Parent s/guardian s Name ([ ]) ([ ]) ([ ]) ([ ]) Home Phone Work Phone Home Phone Work Phone City, State ZIP Code City, State ZIP Code Alternative Emergency Contacts Primary Emergency Contact Secondary Emergency Contact ([ ]) ([ ]) ([ ]) ([ ]) Home Phone Work Phone Home Phone Work Phone City, ST ZIP Code City, ST ZIP Code

4 Medical Information Hospital/Clinic Preference Physician s Name Phone Number Insurance Company Policy Number Allergies/Special Health Considerations/Dietary Restrictions I authorize all medical and surgical treatment, X-ray, laboratory, anesthesia, and other medical and/or hospital procedures as may be performed or prescribed by the attending physician and/or paramedics for my child and waive my right to informed consent of treatment. This waiver applies only in the event that neither parent/guardian can be reached in the case of an emergency. I give permission for my child to go on field trips. I release Dauphin County Technical School and individuals from liability in case of accident during activities related DCTS Career Camp, as long as normal safety procedures have been taken. Witness Signature

5 Career Camp Media Release Form Dauphin County Technical School, in an effort to highlight our school and Career Camp, will share news about activities and events with the local media (TV, print and radio) as well as on our website and newsletters. Please indicate below by checking YES or NO if you do or do not want your child s name and/or photo appearing in such publications. Thank you. YES I consent to having my child s name and photo appearing in DC Tech publications and local media, including but not limited to television, radio, newspapers, school publications and website. NO I object to having my child s name and photo appearing in DC Tech publications and local media, including but not limited to television, radio, newspapers, school publications and website. Name of Child (Please Print): Parent/Name of Guardian (Please Print): Signature of Parent/Guardian: :

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