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MO’RE THAN YEARBOOK 2015/2016 WORKSHOP SERIES Individual Participant Registration Form for Adviser and Staff members
All participants (Advisers and Students) • Please return this form before you participate in your first workshop of the series. • Your response will be recorded and you can now participate at all MO’re than Yearbook Workshops in 2015/2016 Starting April 7th 2015 that you have paid for. Advisers • Fill out the school form as well as submit the payment. • Send Maureen the names of the participants for each event in an email, mmolofsson@herffjones.com. Payment • Make checks payable to MO’re Yearbooks • We prefer individuals pay the school and one check be submitted with the school form • Mail to Maureen Olofsson at 3 s 154 Park Blvd, Glen Ellyn, IL 60137
Registration Conformation June 18th One Day Workshop Emergency Authorization: In consideration of the • $50.00 per participant benefits to be derived and having full confidence After School workshop series that every precaution will be taken to ensure the • $10.00 per participant safety and well-being of my son/daughter or • Series will resume in the fall myself during this activity, I hereby agree to his/ • Participant Name (first and last) her/my participation in any or all MO’re than Yearbook workshops in 2015/2016, I furthermore authorize the staff of the camp to seek any medical • Participants email help and hospital attention for me (in the case of attending adviser) or my minor child (campers). • School (please do not abbreviate) I will not hold Lake Forest Academy, Vernon Hills High School, MO’re Yearbooks, Maureen Olofsson, Jamie Silver, Joelle Sexton, Ann Urbanic, Dan • Publication (please choose one) Eichmeier, Tom Neiman or any member of the staff Yearbook responsible for any accidents or personal injury Newspaper or theft or damage to personal property for any Lit Mag reason whatsoever. Limited space is available at all workshops, I give MO’re Yearbooks permission Broadcasting to publish in print, electronic, or video image of Other my child or use audio recordings of my child. I release all claims against MO’re Yearbooks with • Your Role (please choose one) respect to copyright ownership and publication Adviser including any claim for compensation related to use of the materials. Images, video and audio Editor recordings of my child taken or recorded on the Staff date below by MO’re Yearbooks can be used in print, broadcasting and other forms of advertising; • Adviser(s) Names(s) brochures, newsletters and other camp promotion publications; on a camp web site; in audiovisual presentations; and in other activities to promote • Advisers email 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 • Advisers Phone fees, royalties or other remuneration. Students will not be identified by school or by name in any • Emergency Contact (first and last name and relationship) publication.
• Emergency Contact phone number
As the legal guardian of the participant or participant over 18, I agree to the terms above. PLEASE SIGN HERE If you have any questions, please contact your Adviser or Maureen Olofsson (workshop coordinator) mmolofsson@herffjones.com or 630-660-3773