Beruflich Dokumente
Kultur Dokumente
sponsored by the
The Department of Student Activities and Athletics The School Board of Broward County, FL
sponsored by
The Department of Student Activities and Athletics The School Board of Broward County, FL
Do delegates need to bring a coat and tie or nice dress for a special event?
No. It is highly recommended that shorts be worn as often as possible. Please remind all delegates that the dress code of the School Board of Broward County will be enforced and delegates should pack accordingly.
How can I get permission to participate in the activities that will be conducted by Boot Prints?
Page 15 of this booklet contains the Informed Consent and Assumption of Personal Responsibility Form pertaining to the activities conducted by Boot Prints, Inc.
What is the registration fee, who are checks made payable to, and what is the registration deadline?
The registration cost is $350.00 per delegate and all checks must be made payable to: SBBC-Student Activities. Note: Delegates on the waiting list should not be included. Waiting List delegate fee of $350.00 and paperwork should be forwarded upon notification. There are some special financial arrangements for Broward County traditional schools. The deadline for registration is June 17, 2011. Checks, completed registration forms, permission forms and medical information forms should be sent to: Student Activities Office School Board of Broward County P.O. Box 5408 Ft. Lauderdale, FL 33310
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______________________________________________________________________________ Telephone
_______________________________________ Number of Male Adult Delegates ________________________________________ Amount of Check Enclosed (Total # of Delegates is _____ x $350.00)
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________________________________________________________________________________ If yes, please explain. Does the student have any allergies ____Yes ____No.
________________________________________________________________________________ If yes, please explain. Does the student have a special diet? ____Yes ____No.
________________________________________________________________________________ If yes, please explain, Is the student taking some type of medication ____Yes ____No.
________________________________________________________________________________ If yes, please explain. Note: All medications (prescription and over the counter) must be declared at camp check in.
Student Delegate Email Address: _________________________________________________________ Parent/Legal Guardian Name: ___________________________________________________________ (Please print or type) Parent/Legal Guardian Signature: __________________________________________________ Home Phone: ( ____) ____________________Work Phone: ( ____)______________________
Insurance Information: Company Name: _________________________________Policy Number: ____________________ No Insurance Parent/Legal Guardian Acceptance of Financial Responsibility Signature: ______________________________________ MEDIA RELEASE I grant South Florida Leadership Training Camp/School Board of Broward County and persons acting for or through them, the rights to use, reproduce, assign, and/or distribute photographs, films, videotapes, and sound recordings of myself, for use in any materials they may produce. I understand that I will receive no compensation for such use of materials. Student: ________________________ Parent/Guardian:____________________________
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SFLTC MEDICAL INFORMATION FORM School: _____________________________________ Student: _____________________________________ 1. In case of emergency, Please contact: D.O.B. __________________
2. The above student has the following allergy or other medical condition for which he or she is taking medications also listed: _____________________________________ ___________________________________________________________________ _____________________________________________________________________
3. The above student does/does not (please circle one) have permission to swim on the field trip. 4. In case of emergency, please provide the name of the insurance company which covers the above student for medical services. Also provide any identification or serial name necessary and the name of the person who holds the policy (if its a group-family policy): ______________________________________________________________ _____________________________________________________________________ 5. Doctors Name (family physician) ________________________________________ Telephone Number ( __ )___________________ Parent/Guardian Signature ___________________________________Date ____/___/__
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ARRIVAL FORM
STUDENT: ___________________________________________________ SCHOOL: ___________________________________________________ If you are traveling by train or bus, please complete Section A. If you are traveling by air to Ft. Lauderdale Hollywood International Airport, please complete Section B. SECTION A:
ARRIVAL DATE: _____________ DEPARTURE DATE: ___________
______Ft. Lauderdale Bus Terminal ______Ft. Lauderdale Amtrack Station ______Ft. Lauderdale Tri-Rail Station
ARRIVAL TIME: _______AM PM DEPARTURE TIME: _______AM PM
SECTION B:
ARRIVAL DATE: ______________ ARRIVAL TIME: ______AM PM AIRLINE: ______________________ FLIGHT NUMBER: ____________ DEPARTURE DATE: _______________ DEPARTURE TIME: _________AM PM AIRLINE: _________________________
NOTE: The South Florida Leadership Camp staff will provide transportation from these stations for students arriving prior to 2:30p.m. on Monday, July 18, 2011, and to these stations for students departing after 9:30a.m. on Saturday, July 23, 2011.
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The Commons
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Special Thanks to The School Board of Broward County, Florida Chairperson Benjamin J. Williams Vice Chairperson Ann Murray Robin Bartleman Maureen S. Dinnen Patricia Good Jennifer Leonard Gottlieb Laurie Rich Levinson Nora Rupert David Thomas, NBCT And James F. Notter Superintendent of Schools
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