Dec 13th CCT Registration

Student Name*

First NameLast Name

School-Provided Email*

Confirmation EmailPlease re-enter your email address for verification.

Secondary Email

If you would like registration notifications sent to an additional email

Student Mobile Phone Number

We will send text message reminders about your registration to the phone number provided.

Grade*

School*

Other:

Please enter the name of your school.

Parent/Guardian Name*

First NameLast Name

Parent/Guardian Email*

Please provide an email for a parent/guardian to receive registration notifications.

Parent/Guardian Phone Number*

Please provide a preferred parent/guardian phone number.

Emergency Contact*

First NameLast Name

Emergency Contact Phone Number*

Please enter a valid phone number.

Friday, December 13th:*

St. Paul College (9:00am-2:00pm)

Select a Pathway at Saint Paul College for this Tour*

Trades: Carpentry, Truck Technician and MoreHospitality: Cosmetology, Culinary and More

PLEASE NOTE: All tours start at the Project Success office located at 1 Groveland Terrace, Minneapolis, MN 55403. If needed, shuttle buses are provided from various locations to get to the Project Success office.

Are you planning to take a shuttle bus to get to Project Success?*

YesNo

Please choose your shuttle bus pick-up location:*

Do you have any dietary needs?*

Do you have accessibility needs?*

YesNo

Please describe your accessibility needs:*

Do you have any additional questions or comments?

0/500

Are you 18 years of age or older?*

YesNo

If you are under the age of 18, a parent/guardian signature is required to submit the form.

I, the undersigned hereby agree to participate in Project Success activities, including but not limited to any PS Activities (collectively, “PS Activities”):

1. I grant Project Success permission to create and use photographs, video or other recordings of myself in any format, including but not limited to still or moving images and/or audio, in its and/or PS Activities publications and promotional materials (the “Photos/Videos”). I agree that the Photos/Videos shall be the property of Project Success and there will be no financial compensation of any kind for any Photos/Videos. I irrevocably authorize Project Success to edit, copy, exhibit, publish, or distribute the Photos/Videos for any lawful purpose and waive the right to inspect or approve the finished Photos/Videos.

2. I understand that there are inherent hazards and risks associated with my participation in PS Activities, some of which are unknown, including but not limited to loss or damage to personal property and/or minor or serious emotional and/or bodily harm, paralysis or death from accidents, falls, cuts, drowning, hazardous weather, illness, injury or other events. I agree that I am responsible to independently investigate the potential hazards and risks any PS Activities. I understand that Project Success is not an agent of, and cannot control the acts or omissions of any transportation carrier or other provider involved in PS Activities. I agree to and do hereby assume all hazards and risks, known or unknown, related to PS Activities. I also agree to immediately advise a Project Success representative if I feel that any facility, equipment or other conditions are unsafe.

3. With full knowledge and understanding that my participation in PS Activities carries known and unknown hazards and risks, I and any other person or party who could bring a claim on my behalf, hereby release and forever discharge and hold harmless Project Success and its successors or affiliated organizations (including but not limited to the Minneapolis Public schools, St. Paul Public Schools, any other sponsoring organization, and/or any affiliated clubs), and each of their respective past, current or future directors, members, officers, employees, volunteers, donors, guests, and agents, from any and all liability, claims, demands, and costs of whatever kind or nature, either in law or in equity, related to or arising out of my participation in PS Activities, including without limitation, for injury, illness, emotional or bodily harm, death, medical treatment decisions, medical costs, property loss or negligence.

4. I agree that I am responsible for my medical needs, costs, and insurance coverage, including health, vision, dental, accident, disability, life and any other insurance. There either are no health-related issues which restrict my participation in PS Activities or, if special assistance is needed, I have arranged this with Project Success. If I should need medical treatment, Project Success is authorized to arrange such care and provide consent for emergency treatment if unable to reach me to arrange for my timely consent to such treatment

BY SIGNING BELOW, I REPRESENT THAT I AM AT LEAST 18 YEARS OLD, I HAVE READ AND UNDERSTAND THIS AGREEMENT, AND I VOLUNTARILY ENTER INTO IT WITH KNOWLEDGE THAT IT CONTAINS A LEGAL WAIVER OF LIABILITY AND INTENDING TO BE LEGALLY BOUND BY THIS AGREEMENT.

I, the undersigned legal guardian, hereby agree to the following in consideration of my minor child’s opportunity to participate in Project Success activities (collectively, “PS Activities”):

1. I grant Project Success permission to create and use photographs, video or other recordings of my child in any format, including but not limited to still or moving images and/or audio, in its and/or PS Activities publications and promotional materials (the “Photos/Videos”). I agree that the Photos/Videos shall be the property of Project Success and there will be no financial compensation of any kind for any Photos/Videos. I irrevocably authorize Project Success to edit, copy, exhibit, publish, or distribute the Photos/Videos for any lawful purpose and waive the right to inspect or approve the finished Photos/Videos.

2. I understand that there are inherent hazards and risks associated with my child’s participation in PS Activities, some of which are unknown, including but not limited to loss or damage to personal property and/or minor or serious emotional and/or bodily harm, paralysis or death from accidents, falls, cuts, drowning, hazardous weather, illness, injury or other events. I agree that I am responsible to independently investigate the potential hazards and risks any PS Activities. I understand that Project Success is not an agent of, and cannot control the acts or omissions of any transportation carrier or other provider involved in PS Activities. I agree to and do hereby assume all hazards and risks, known or unknown, related to PS Activities. I also agree to instruct my child to immediately advise a Project Success representative if my child feels that any facility, equipment or other conditions are unsafe.

3. With full knowledge and understanding that my child’s participation in PS Activities carries known and unknown hazards and risks, I, on behalf of myself and my child and any other person or party who could bring a claim on either of our behalf, hereby release and forever discharge and hold harmless Project Success and its successors or affiliated organizations (including but not limited to the Minneapolis Public schools, St. Paul Public Schools, any other sponsoring organization, and/or any affiliated clubs), and each of their respective past, current or future directors, members, officers, employees, volunteers, donors, guests, and agents, from any and all liability, claims, demands, and costs of whatever kind or nature, either in law or in equity, related to or arising out of my child’s participation in PS Activities, including without limitation, for injury, illness, emotional or bodily harm, death, medical treatment decisions, medical costs, property loss or negligence.

4. I agree that I am responsible for my child’s medical needs, costs, and insurance coverage, including health, vision, dental, accident, disability, life and any other insurance. There either are no health-related issues which restrict my child’s participation in PS Activities or, if special assistance is needed, I have arranged this with Project Success. If my child should need medical treatment, Project Success is authorized to arrange such care and provide consent for emergency treatment if unable to reach me to arrange for my timely consent to such treatment

BY SIGNING BELOW, I REPRESENT THAT I AM AT LEAST 18 YEARS OLD, I AM THE LEGAL GUARDIAN OF THE CHILD LISTED BELOW, I HAVE READ AND UNDERSTAND THIS AGREEMENT, AND I VOLUNTARILY ENTER INTO IT WITH KNOWLEDGE THAT IT CONTAINS A LEGAL WAIVER OF LIABILITY AND INTENDING TO BE LEGALLY BOUND BY THIS AGREEMENT.

Please type your full name*

First NameLast Name

Signature*

SF Cohort Id

SF Program Id

DO NOT CHANGE THIS FOR CLONED FORMS until the school year changes over..

SF Service ID

CCT Participation Hours- Do not change until next school years form

Selected Tour Service Schedule ID

When there is only one schedule, the Service Schedule Id can be placed directly in this box.

Transportation Type

Waiver Year

Requested

Saint Paul College Tour

Student Information

Parent/Guardian Information

Registration Information