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Please photocopy this form for your records.
SCHOOL REGISTRATION FORM all advisers must complete one school form.
Turn this form with payment.
MAUREEN OLOFSSON - CAMP DIRECTOR 630-660-3773 mmolofsson@herffjones.com Mail to: Maureen Olofsson MO’re than JOURNALISM 3s154 Park Blvd. Glen Ellyn, Illinois 60137
SCHOOL INFORMATION: Please print neatly. _______________________________________________________ School Name
Please submit one check per school made payable to: MO’re Yearbooks
_______________________________________________________ School Address
Space is limited, Full refunds for the June 18th event may only be obtained prior to May 15 2015. A 50% refund may be obtained before June 1, 2015. No refunds will be given after June 10, 2015.
_______________________________________________________ City / State / Zip
_______________________________________________________ School Phone
_______________________________________________________ Adviser #1 Attending
YES
WEEKLYSERIES April 14 THEME
No# Attendees ________ @ $10 = $___________
NO
April 21 PHOTO/PHOTOSHOP ________ @ $10 = $___________ _______________________________________________________ Cell Phone of at least one adviser
April 28 PAGE DESIGN
_______________________________________________________
May 5 ADVISER (No Students) ________ @ $10 = $___________ No# of discounts 5 + Students per event - Adviser FREE ________ @ $10 = $ -- _________
Email of at least one adviser
_______________________________________________________
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Adviser #2 Attending
YES
NO
PLEASE SIGN: _______________________________________________________
________ @ $10 = $___________
No# Attendees ONE DAYEXPRESS June 18 ONE DAYEXPRESS ________ @ $50 = $___________ No# of discounts 5 + Students per event - Adviser FREE ________ @ $50 = $ -- _________ No# Attendees per cycle
Signature of Adviser
_________________________________________________ - 2015 Date
Emergency Authorization: In consideration of the benefits to be derived and having full confidence that every precaution will be taken to ensure the safety and well-being of my son/daughter or myself during this activity, I hereby agree to his/her/my participation in the MO’re Yearbooks, to be held at Lake Forest Academy High School, Lake Forest, Illinois and Vernon Hills High School, Vernon Hills, Illinois. I furthermore authorize the staff of the camp to seek any medical help and hospital attention for me (in the case of attending adviser) or my minor child (campers). I will not hold Lake Forest Academy, Lake Vernon Hills High School, Herff Jones Inc., MO’re Yearbooks, Maureen Olofsson, Jamie Silver, Joelle Sexton, Ann Urbaniec, Dan Eichmeier, Betty Samples, Karl Boettcher, VIP Photography, Tom Neiman, NFHS Broadcasting or any member of the staff responsible for any accidents or personal injury or theft or damage to personal property for any reason whatsoever. Limited space is available, full refunds for the June 18th event may only be obtained prior to May 15, 2015. A 50% refund may be obtained before June 1, 2015. No refunds will be given after June 10, 2015. I give MO’re Yearbooks permission to publish in print, electronic, or video images of my child (or myself) or use audio recordings of my child (or myself). I release all claims against MO’re Yearbooks with respect to copyright ownership and publication including any claim for compensation related to use of the materials. Images, video and audio recordings of my child (or myself) taken or recorded on the date(s) indicated on this form by MO’re Yearbooks and their staff can be used in print, broadcasting and other forms of advertising; brochures, newsletters and other camp promotion publications; on websites; in audiovisual presentations; and in other activities to promote the camp and inform the public about the camp. These photos, video or other images or recordings may be used by the camp without payment of fees, royalties or other remuneration. Students will not be identified by school or by name in any publication or online.
ADVISER
DESIGN YEARBOOK
DESIGN NEWSPAPER
DESIGN LIT MAG
PHOTO & PHOTOSHOP
COPY & CAPTIONS
BROADCASTING SCHOOL CHECK NO. ________________ TOTAL $ _____________ CPDU Credit desired STUDENTS FORMS NEEDS Once the School form is received the Adviser will be e-mailed a link with the student form that needs to be signed by a parent or guardian and e-mailed back to mmolofsson@herffjones.com prior to attending first event. One form is good for all events in the 2015-2016 school year.