TROWT Summer Teen Program Registration - 2023 Program Goals & Participation Requirements*Great Lakes Aquarium programs aim to: - Ensure the safety and well-being of all participants - Offer the opportunity for each participant to feel successful - Offer the opportunity to experience social development and authentic learning as well as service and leadership skills In order to participate in this program, participants must be able to: - Take care of their own personal needs (snacks, bathroom, etc.) - Interact safely and respectfully with fellow participants and Aquarium guests - Work independently, cooperate safely with peers, and follow verbal directions - Identify and advocate for their own allergies/medical needs, especially regarding seafood - Conduct themselves appropriately and responsibly on off-site field trips Please note: while Aquarium staff is trained in group management, activity facilitation, and considerations for students with special needs, they are not necessarily certified in special education and cannot provide one-on-one support. If your child needs individualized support at school or home, they are welcome to participate but must be accompanied by an aide, caregiver, or respite provider (at no extra cost to the accompanying adult). If you have concerns that your child may have difficulty or require assistance with any of these requirements, contact Community Learning Manager Ahna Neil at aneil@glaquarium.org or 218-740-2025 to discuss options for your child. I have read and understand the program participation requirements. Parent/Guardian Name* First Last Participant Name* First Last Participant's Gender Pronouns* He/Him She/Her They/Them Participant's Age (must be between the ages of 13-18 at the start date of the program)* Participant's emailWhen possible, we prefer to correspond directly with teen participants. This email address will be used to send any updates about the program throughout the summer. Parent/Guardian Phone Number*Parent/Guardian Email Address* Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Alternate Contact Name* First Last Alternate Contact Phone*Registration QuestionnaireThe following questions should be filled out by the program participant. Do you have a particular area of interest among the topics/exhibits at the Aquarium (e.g. sturgeon, climate change, geology, etc.)? Please indicate your interest here so we can do our best to incorporate it into our plans for the summer!What do you hope to get out of your time with the Aquarium?Possible examples include leadership experience, volunteer experience, a chance to make new friends, etc.If you could snap your fingers and change the world in one way, what would you change and why?Health FormGreat Lakes Aquarium is committed to creating a welcoming and inclusive environment for all participants. Please provide as many details about your child and their needs as possible so that we can provide a fun, safe and educational experience.Allergies*Does this participant experience an allergic reaction to any of the following? Select all that apply. Foods Medications Environmental factors (insect stings, pollen, etc) Other None of the above Please describe the specific allergen, symptoms, severity of reaction, and usual treatment steps:*Medical History*Does this participant have a history of any of the following medical conditions? Seizures Diabetes Migraines Back Problems Knee/Joint Problems Dizziness/Fainting Respiratory Problems Asthma (Cold or Exercise Induced) Heart Disease Abnormal Blood Pressure Recent Injury Skin Conditions Mobility Limitation Vision/Hearing Impairment Travel Outside the Country (within 6 months prior to camp) Other None of the Above For each item checked under "Medical History," please describe the symptoms and usual treatment steps.*Sensory Triggers*Does the participant experience any sensitivities to sounds, lights, smells, textures, or other unique needs that program staff should be made aware of? Yes No Please describe the participant's sensitivities/triggers and any accommodations Aquarium staff can provide to give the participant the best experience possible. (It may be helpful to share parts of your school's Individualized Education Plan (IEP), school behavior plan, or home routines that support a successful day):*Great Lakes Aquarium Waiver and ReleaseTo be filled out by the parent or guardian of the participant (if participant is under the age of 18).Parent/Guardian Acknowledgment* I am the parent or guardian of the participant. I understand, answer, and agree to each of the questions in this application on behalf of the participant.Participant Waiver*I understand that I (or my child) am participating in the above program at our own risk. I will not hold Great Lakes Aquarium or its officers, directors, employees, or volunteers liable for any negligence or alleged negligence or other fault (not including intentional acts) that results in personal injury, death, or property damage during or in connection with the above program. The undersigned, for myself and for my heirs, executors, administrators and assigns, hereby release and forever discharges Great Lakes Aquarium and its officers, directors, employees, and volunteers from all such claims. The waiver will be construed according to the law of the State of Minnesota. I understand and agree to the Participant Waiver.Medical Release*I hereby give my permission for Great Lakes Aquarium to procure all necessary medical help for myself, my child or ward while said person is under the direct supervision of Great Lakes Aquarium, and grant permission to its representatives to authorize any competent medical professional to do all things reasonably necessary to take care of any injury or sickness. I understand and agree to the Medical Release.Transportation Services Waiver*Please read this form carefully and be aware that in consideration for the Great Lake Aquarium providing transportation services in connection with the TROWT Program, you will be expressly assuming the risk and legal liability and waiving and releasing all claims for injuries, damages, or loss which you or your minor child/ward might sustain as a result of said services, including but not limited to, vehicle operations and boarding and exiting the vehicle. I recognize and acknowledge that the Great Lakes Aquarium is neither a common carrier nor in the business of providing transportation services to the public. I further recognize and acknowledge that there are certain risks of physical injury to vehicle passengers, and I voluntarily agree to assume the full risk of any injuries, damages, or loss, regardless of severity that my minor child/ward or I may sustain as a result of participating in any and all activities connected with or associated with receiving transportation services, including, but not limited to, injuries, damages, and loss arising out of negligent operation or supervision of the vehicle. I further agree to waive and relinquish all claims I or my minor child/ward may have (or accrue to me or my child/ward) against the (Great Lakes Aquarium), including its respective officials, agents, volunteers, and employees (hereinafter collectively referred as “Parties”). I do hereby fully release and forever discharge the Parties from any and all claims for injuries, damages, or loss that my minor child/ward or I may have or which may accrue to me or my minor child/ward and arising out of, connected with, or in any way associated with said transportation services. I further agree that this agreement shall be governed by the laws of the State of Minnesota. I understand and agree to the Transportation Services Waiver.Quarantine and COVID Policy*Great Lakes Aquarium will use the most updated version of the Minnesota Department of Health's Recommended Decision Tree for People in Schools, Youth, and Childcare Programs to inform decisions about camp quarantine and/or masking in the event of a COVID-19 exposure. I understand and agree to the Quarantine and COVID policy.Photo Release*I grant permission for Great Lakes Aquarium to use photos and/or video of this child in: (Check all that apply) Print and digital publications and Aquarium promotional materials The Aquarium's social media pages Local news media (newspaper, television, web content, etc.) in the event the program is featured in local news None of the above
