AIESEC United States Exchange Participant Policies
Contents I. AIESEC Exchange Program .............................................................................................................. 2 I.i. The Exchange Program must aim to provide the EP with: ................................................. 2 I.ii. The Exchange Program cannot aim to: .................................................................................. 2 I.iii. Exchange Program Criteria: ..................................................................................................... 3 I.iv. Exchange Program Quality Standard .................................................................................... 3 I.v. Glossary of Terms ........................................................................................................................ 3 i.vi. Exchange Program Descriptions ............................................................................................ 5 II. Exchange Participant ........................................................................................................................ 7 II.i. An Individual can participate in the Exchange Program: .................................................. 7 II.ii. An individual does not have the right to apply for the AIESEC Exchange Program: ................................................................................................................................................................. 7 II.iii. Rights of the EP: ........................................................................................................................ 7 II.v. Responsibilities of the EP: ....................................................................................................... 8 II.vi. The EP has the right to break the realization if one of the following situations applies: ................................................................................................................................................ 10 II.vii. The Hosting entity/organization has the right to break the realization with the EP if one of the following situations applies: ...................................................................................... 11 III. Reintegration .................................................................................................................................... 11 III.i. The EP has the right to participate in existing reintegration activities of the sending entity. Reintegration should include: .......................................................................................... 11 III.ii. The EP must provide the sending Local Committee one or more of the following documents and files, to be completed either during the internship or upon completion: ............................................................................................................................................................... 11 IV. Financial Responsibilities ............................................................................................................ 12 IV.i. Program Fees: ........................................................................................................................... 12 IV.ii. Refunds: ..................................................................................................................................... 13 V. Responsibilities Not Covered in this Contract ......................................................................... 13 V.i. Hosting Committee: .................................................................................................................. 13 V.ii. Travel Advisories: ..................................................................................................................... 13 VI. Signature ........................................................................................................................................... 14 AIESEC United States Exchange Participant Policies; Statement of Understanding
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Participant Statement of Understanding I,_______________, as a participant of an AIESEC overseas Exchange Program understand and hereby agree to follow all the terms, conditions and responsibility of myself stated in the AIESEC Exchange Program Policies as well as following statements: i.
To be responsible for own participation to the AIESEC oversea activity program and act with own safety as the first priority;
ii.
To be responsible for own decisions of going to the destination country/territory and for any safety risks it contains;
iii.
To be liable for any harms caused by own actions to any stakeholders involved;
iv.
To have oversea travel and health insurance as own responsibility, and take vaccination if necessary;
v.
To inform the contact details in the destination prior to leave the home country/territory, to their family and the Sending Entity AIESEC committee.
vi.
To educate self and adhere to the Exchange Program Policies (XPP) of AIESEC International.
I. AIESEC Exchange Program An AIESEC Exchange Program is a practical working and learning experience for the Exchange Participant, hereafter referred to as the EP, to develop their leadership abilities and competencies of Global Mind-set, Entrepreneurial Outlook, Social Responsibility, Emotional Intelligence and Proactive Learning in a foreign cultural environment.
I.i. The Exchange Program must aim to provide the EP with: a) A positive learning experience; b) An opportunity for leadership development; c) Interaction with a different social and cultural environment with a view to gaining intercultural competencies; d) Development of theoretical and practical leadership skills; e) Opportunity to apply personal and professional skills, knowledge, attitudes and values to work for the organization as well as the host communities; f) Develop awareness and knowledge of social issues and different practices of the sending and hosting country; g) Opportunity to contribute to personal and professional life goals.
I.ii. The Exchange Program cannot aim to: a) Solely provide an opportunity for the EP to earn money; b) Provide a holiday; AIESEC United States Exchange Participant Policies; Statement of Understanding
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  c) Act as a permanent career placement or recruitment opportunity. If the organization decides to extend the program on a permanent basis, AIESEC will have no role in facilitating this; d) Provide permanent residence in the hosting country; e) Be an internal AIESEC leadership position.
I.iii. Exchange Program Criteria: a) Minimum 6 weeks to maximum 78 weeks, extension must not be accepted for over a total of 78 weeks with the same hosting organization. If the hosting organization and intern agree to extend the program, AIESEC will have no responsibility or role in facilitating this; b) Meet the national and local legal requirements in both hosting and sending country. In case of any difference or contradiction between the referred rules, it the regulation which offers more benefit to the EP shall prevail; c) Have a hosting organization that provides clear legal status for visa invitation and other conditions in the hosting country as the TN taker, fulfilling all its responsibilities as described in the XPP; d) An EP must be at the age of 30 or under, AND a current student or within 2 years after graduation from their last university degree at the time of the match of the Exchange Program; e) Execute and delivery to AIESEC US the AIESEC US Exchange Program Waiver, which is attached to the this Statement of Understanding as Appendix A.
I.iv. Exchange Program Quality Standard a) The AIESEC Exchange Program conditions must be clearly explained in the TN form on myaiesec.net. Thus through the exchange of the Acceptance Notes, the EP is immediately accepting the Quality Standard specified by the TN he/she is accepting. The Quality Standard must include, but is not limited to: i) The amount and form of salary provided to the EP; ii) Accommodation, and its exact condition (such as single room, host family); iii) Accommodation, transportation, insurance and visa cost payment responsibility; iv) Other living conditions, if any, (such as providing food) and necessary costs for both the hosting organization and the EP.
I.v. Glossary of Terms Term Global Exchange Program or Exchange
Definition Refers to the AIESEC Exchange Programs, including the Global Community Development Program (GCDP) and Global Internship Program (GIP)
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Global Internship Program (GIP)
An opportunity for an EP to develop entrepreneurial and responsible leadership by living a cross-cultural professional developmental experience. Refer details to I.v. of this policy.
Global Community Development Program (GCDP)
An opportunity for EP to develop entrepreneurial and responsible leadership by creating direct positive impact through an international volunteer experience. Refer details to I.v. of this policy.
Intern or Exchange Participant (EP)
AIESEC members participating in the Global Exchange Programs and going through all stages of the Exchange process.
Organization (TN Taker) A corporate, non-governmental or governmental entity hosting the EP during the Exchange Programs. Local Committee (LC)
Any local headquarter formally recognized as such by AIESEC International. An LC can send its members abroad or receive EPs.
Sending AIESEC Entity (SE)
Official Local or Member Committee of AIESEC or AIESEC International which carried out the selection process of an EP, uploaded its form to myaiesec.net, and is or was responsible for its preparation, matching, and reintegration.
Hosting AIESEC Entity (HE)
The official Local or Member Committee of AIESEC that carries out the Exchange Program with an organization by uploading the exchange form to MyAIESEC.net, matching it, and organizing the EP’s reception and integration.
Member Committee (MC)
Any country or territory headquarter formally recognized as such by AIESEC International. The Member Committee is the final responsible regarding the activities of any of its Local Committees.
Sponsor Member or Sponsoring Country
A sponsor member is the Member Committee which is supporting the extension of AIESEC to a new country or territory.
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AIESEC International (AI)
Foundation administered by the Management Board of Stichting AIESEC International, having its official office located at 126 Teilingerstraat, NL-3032 AW Rotterdam, The Netherlands. It is the highest governing body of AIESEC overlooking operations of the global AIESEC network.
Acceptance Note (AN)
The official document contained in the appendices of the Exchange Program Policies; Appendix B – EP Acceptance Note and Appendix C – TN Acceptance Note. The AN form contains the final conditions of the particular exchange as agreed by all involved parties.
Exchange Program Policies (XPP)
The official international program policies governing all AIESEC exchange experiences, as legislated annually at International Presidents’ Meeting.
i.vi. Exchange Program Descriptions TNs should be classified as Global Internship Program (GIP) or Global Community Development Program (GCDP) based on the criteria defined in this below descriptions. EPs should be classified as GIP or GCDP based on the program they have the highest interest in as outlined in this below descriptions.
Global Internship Program
Global Community Development Program
Definition:
An opportunity for an EP to develop entrepreneurial and responsible leadership by living a cross-cultural professional development experience.
An opportunity for EP to develop entrepreneurial and responsible leadership by creating direct positive impact through an international volunteer experience.
EP can gain:
Access to AIESEC’s valuebased platform where he/she experience a cross-cultural living and working experience. A professional development experience.
Access to AIESEC’s valuebased platform where he/she experience a cross-cultural living and working experience. Opportunity for creating positive social impact, leadership, and personal
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development.
Criteria of the Program portfolio:
Hosting Entity to provide an internship in an hosting organization, through which an EP contributes to the goals of the organization, completes a job description requiring special expertise or skills, and receives supervision and evaluation on his/her professional development. This includes the development of practical skills and knowledge in a foreign environment to complement the EP’s higher educational background or field of career aspirations.
TNs/Partners Criteria
Organizations that support AIESEC’s values and aim to enhance their organization through involving global top talent, improving their processes or growing their organizational performance. With these organizations, AIESEC ensures legal state of the EP in the country/territory and co-create opportunities for EPs to work, learn and contribute to the organization’s goals.
At least 35h/week
Hosting Entity to provide an international volunteer experiences through which EPs develop themselves while empowering individuals, communities or organization. Be focused on areas and issues with the needs for direct social impact and sustainable solutions. GCDP EPs may have different type of volunteer experiences, including using professional skills, to contribute to their personal development and positive impact on the society.
Organizations which aim to create or support direct positive impact in communities through their activities, initiatives, or projects. With these organizations, AIESEC co-creates opportunities for EPs to develop themselves while providing direct positive impact. Can be from public, private, or social sector, or a project (which must involve one or more organizations as An AIESEC entity cannot solely deliver a GCDP experience without any external involvement.
At least 25h/week
Working regime
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II. Exchange Participant II.i. An Individual can participate in the Exchange Program: a) If he/she meets all the requirements of an Exchange Participant as set out in i) AIESEC Untied States Exchange Participant Contract ii) AIESEC International’s Exchange Program Policies (XPP)
II.ii. An individual does not have the right to apply for the AIESEC Exchange Program: a) If he/she does not have the capacity to enter into legal agreements in its sending country, cannot legally travel abroad independently, with or without parent’s formal authorization and without requiring the Hosting AIESEC Entity to have legal power of attorney over the individual; b) If he/she previously violated the XPP.
II.iii. Rights of the EP: a) To take up a maximum period of 36 months of Exchange Program in total. These 36 months can be allocated whenever and in whichever order, so long as they follow the minimum and maximum duration of AIESEC exchanges as outlined in section 1 of this document, and respect all of the policies outlined in the XPP; b) To apply for an Exchange with an AIESEC entity in any country or territory in which he/she has lived for a minimum period of six (6) weeks; c) To have an Exchange in any country/territory with the exception of countries/territories in which they have lived for more than two (2) years in the last ten (10) years. The starting date of the last ten (10) years should be considered from the date that the EP applies to the Exchange selection process. CEED/MC/AI experiences may be excluded from this two-year period; d) An EP may officially accept any TN form either by accepting the TN form on myaiesec.net and sending the link of an uploaded official signed Acceptance Note to TN Manager, or alternatively by directly sending an official signed Acceptance Note to TN manager; e) Acceptance of TN form automatically means the EP is accepting the particular exchange with all its conditions, as described in the TN form available in myaiesec.net unless otherwise stated in the Acceptance Note; f) Acceptance of TN form automatically means that the EP is guaranteed as available for the exchange while Acceptance Note is valid; g) Acceptance is valid for ten (10) subsequent days after official acceptance of TN in accordance to point f); AIESEC United States Exchange Participant Policies; Statement of Understanding
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  h) Acceptances may be extended (e.g. for additional selection procedure) using myaiesec.net through uploading a new Acceptance Note or after mutual agreement between parties. Both parties must agree to the extension; i) If the EP rejects the TN form after he/she has officially accepted the TN in accordance to point d) and the TN has accepted the EP, he/she will no longer be allowed to take part in exchange program through AIESEC; j) Match between an EP and organization is only considered official when both the EP and organization has fulfilled at least one of the requirements below: k) Have accepted each other through myaiesec.net and uploaded their official Acceptance Notes. l) Have been assigned a manual match and both have signed and sent their official Acceptance Notes. m) Receive acceptance note within ten (10) subsequent days after having sent official acceptance of a TN in accordance with point d); n) Officially accept the TN Acceptance Note as the final agreement of all conditions of the particular exchange; o) Withdraw his/her application without consequence after acceptance expires if no mutual extension agreement has been made between the EP and the TN, after the condition in policy g) and h) has passed; p) After providing the passport details, receive, within two (2) weeks, all the necessary documentation from the hosting AIESEC entity (including the written acceptance note/invitation) required for application for a visa/work permit;
II.v. Responsibilities of the EP: a) Complete and enter the forms on myaiesec.net; b) Have written proof of the academic background and working experience specified on the EP forms; c) Go through a language test. Have written proof of the language level(s) specified on the EP forms; d) Participate in and pass a selection process organized by the Local Committee; e) Attend preparation events and complete the preparation requirements of the country and territory; f) Acquire the necessary legal documents to participate in an internship in the foreign country (visa, insurance, working permit and other required documents). A visa application should be submitted no more than two (2) weeks following acceptance of a TN. The EP should incur all expenses; h) Incur all expenses related to transportation to the host country and territory;
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  i) Acquire adequate health and travel insurance for the duration of their time abroad; k) Set personal and professional goals to be achieved during exchange experience; l) Exchange Acceptance Notes with the host organization upon selection by hosting Local Committee to a suitable and desired traineeship, thereby formalizing the traineeship and binding all details set in the traineeship form. The EP must only commit to one traineeship at a time. Failure to comply with this expectation will result in immediate forfeit of access to the online database; l) Maintain email communication with the host and home Local Committees throughout the duration of the internship; m) Inform sending Local Committee within ten (10) days if EP becomes unavailable for a traineeship or decides to leave the program for any reason; n) Complete and submit the Net Promoter Score evaluation within ten (10) days of receiving it from the sending entity. EPs will receive the Net Promoter Score evaluation before, during, and post internship from the sending entity; o) Hold a valid passport, if not apply for a passport so that the validation date covers the entire duration of the exchange; p) Update the Hosting entity about his/her passport application within one (1) week of a match in cases where an application for a passport has been initiated with the government upon acceptance, unless otherwise agreed upon with the hosting AIESEC entity or organization. An EP Acceptance Note may be deemed invalid if this standard is not met; q) Integrate himself/herself in the Local Committee activities in the home and host country and territory, and maintain a positive attitude and open mindset for the duration of the internship; r) Consult the Exchange Program Policies, manager from sending Local Committee, and inform the local and/or Member Committee if he/she becomes unavailable for an internship, or if he/she is looking into other opportunities; s) Review the visa/ work permit regulations for the host country prior to the purchase of a ticket to travel to the country (air/sea/land transportation); t) Provide contact information and emergency contact information with the sending and hosting Local Committees; u) Re-evaluate the options specified on his/her forms if he/she has not been matched after several attempts; v) Ensure that adequate insurance, medical certifications, working & residence permits, and flight arrangements have been acquired for the internship; w) Have enough money to cover his/her living expenses for the first few weeks of the internship; x) Ensure that he/she has a return ticket to his/her home; AIESEC United States Exchange Participant Policies; Statement of Understanding
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y) To inform themselves of the local realities of the host country; z) Be prepared to give presentations about his/her country and culture to company/organization employees, AIESEC members, and other audiences, if requested to do so; aa) Take a proactive and independent role in getting involved in the community and in other activities outside the internship; bb) Give input to the host Local and Member Committees about future internship opportunities with the company/organization he/she is working for to provide similar opportunities to other students in the future (if applicable); cc) Provide feedback to AIESEC United States and the host Local Committee about the internship experience and how the AIESEC exchange experience could be improved in the future; and dd) Participate in the reintegration process of the sending Local Committee.
II.vi. The EP has the right to break the realization if one of the following situations applies: a) The EP has not received all necessary documents required for application for visa/work permit from the hosting LC (including invitation) within two (2) weeks, which has resulted in the EP not being able to commence with the exchange; or the EP was not informed of the timeline for provision of any required documents; b) In the case where the standard under II.v.f) is met by the EP but a delay was caused by third party and this delay fundamentally changes the conditions of the exchange (Proof required); c) The EP has an emergency in his/her family (Proof required). After breaking a match due to family emergency the EP is not allowed to put an EP form on “Available” or raise new EP form on myaiesec.net for the next 6 weeks; d) The EP becomes ill and the situation can be dangerous for his/her health (proof required); e) The EP is in danger due to the area where he/she works being formally declared in emergency due to war, natural disasters, people revolution, and terrorism attacks; f) The EP does not have an official working/living permit in the country of exchange upon arrival, unless other legal options have been agreed upon; g) The exchange job is different to the description the AN form refers to and was not agreed upon by the EP, where the change affects the nature/purpose of the job, or puts the EP in financially or physically disadvantaged state. The EP is expected to try to resolve the issue first with the TN taker and hosting entity;
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h) The EP is discriminated against race, color, gender, sexual orientation, creed, religion, national, ethnic or social origin, or age at his/her work place; j)
The EP is sexually harassed at their work place;
j) The organization does not provide the basic work conditions or any main benefit offered to the EP that the Acceptance Note form refers to and the EP did not agree to the abolition. The basic work conditions or benefits referred above must be of a nature that their abolition reasonably makes impossible or too difficult the EP’s job or living conditions in order for a broken match to be validated. The EP is expected to make certain preliminary steps to resolve the issue, including contacting the hosting entity and actively participating in negotiations with the organization to resolve any issues; k) The TN taker does not pay corresponding salary to the EP for two consecutive months. The EP may still claim accrued salary from the TN taker and hosting entity in case of a broken match.
II.vii. The Hosting entity/organization has the right to break the realization with the EP if one of the following situations applies: a) If the EP has falsified information related to his/her work experience, academic background or language proficiency and is unable to fulfill his/her exchange role as specified in the TN form. b) If the EP is breaking the law of the hosting country, or is continually breaking internal regulations of the organization despite being warned or aware or them.
III. Reintegration III.i. The EP has the right to participate in existing reintegration activities of the sending entity. Reintegration should include: a) The opportunity to debrief the exchange experience with AIESEC in the sending entity; b) The opportunity to evaluate and review the EP’s goal and re-integrate into LC activities (if applicable); c) The opportunity to share the exchange experience with other members of the LC, including outgoing EPs; d) Information about reverse culture shock and how to cope with it; e) Information on how to utilize and position the international exchange experience in a professional resume and in the local job market in general.
III.ii. The EP must provide the sending Local Committee one or more of the following documents and files, to be completed either during the internship or upon completion: a) A written testimonial of the AIESEC Exchange Program; b) An article, minimum 300 words, about the internship, cultural experience and benefits of the AIESEC Exchange Program;
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c) A minimum of 5 quality photos that depict 1) the AIESEC members of the hosting Local Committee; 2) the work environment, including coworkers, if possible; 3) the accommodations and living conditions, including roommates and host families if possible; 4) the local cuisine; and 5) a local landmark or tourist attraction; The EP must provide an evaluation of their exchange experience via the Net Promoters Score, distributed by the sending Local Committee/ Member Committee on three occasions [prior to departure, during internship, and upon return home], as stated in Section II.v.n.
IV. Financial Responsibilities IV.i. Program Fees: a) The EP is required to pay a non-refundable application fee of $150 by credit card at the time of application. Upon payment of this fee, the EP will be provided access to AIESEC’s internal database of opportunities abroad for a period of one year. b) At the time of application on exchange.aiesec.org, the EP will provide AIESEC United States with credit card information to charge their traineeship match fee. AIESEC United States will submit an “authorization” transaction to the credit card to ensure sufficient funds are available on the account. Some credit card companies will make the funds temporarily unavailable after this “authorization” transaction. AIESEC United States is not responsible for any fees or other losses resulting from inability to access these funds, such fees or losses are the responsibility of the EP. c) The EP is required to pay a traineeship match fee at the time the hosting company and EP exchange acceptance notes, thereby binding the agreement between the company and EP. d) Upon exchange of the acceptance notes, the EP status on myaiesec.net will change to “matched”. Once this status has been updated, AIESEC United States will automatically charge the EP’s credit card the appropriate traineeship fee. e) The traineeship match fee is as follows: Global Community Development Program
$350
Global Internship Program [Teaching ]
$350
Global Internship Program
$600
Traineeship type is defined in the job description of the secured traineeship on myaiesec.net. f)
For EPs who are taking their second or third traineeship, the traineeship match fee is as follows: Global Community Development Program
$250
Global Internship Program [Teaching]
$250
Global Internship Program
$450
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Traineeship type is defined in the job description of the secured traineeship on myaiesec.net. g) Should an EP take multiple traineeships, the total duration of all traineeships must not 36 months. h) Should a suitable traineeship be unavailable, or not secured, the EP will not be charged the traineeship match fee.
IV.ii. Refunds: a) Should an EP be charged the wrong traineeship fee, AIESEC United States is responsible to refund the EP; b) Should the traineeship be secured, and the EP does not follow through with their commitment to the traineeship for any reason, the decision to refund the traineeship will be made by AIESEC United States upon receiving a refund request form from the EP. AIESEC United States has the right to maintain sole discretion, and the decision will be final and binding for all parties.
V. Responsibilities Not Covered in this Contract V.i. Hosting Committee: a) AIESEC United States provides EPs with opportunities through host local AIESEC committees, and does not guarantee, nor is responsible for, any performance by the aforementioned AIESEC committees abroad. Should any concern, issue, or problem arise regarding the host AIESEC committee (including, but not limited to: the amount of interaction, living conditions, communications), the EP must directly resolve those issues with the hosting AIESEC committee, or with the Member Committee of the host country in a timely manner.
V.ii. Travel Advisories: a) The United States Department of State posts travel advisories on its website, www.travel.state.gov. AIESEC United States strongly recommends that the EP review this information before securing a traineeship or going abroad; b) AIESEC United States is not liable for any issues that arises while the EP is abroad (including, but not limited to: issues arising in countries under a travel advisory). EPs are responsible for seeking education on topics including (but not limited to) the following: • Official status of the country/ territory of its political situation; • Past terrorism, incidents and natural disasters records, and current status of such safety standard; • Crisis prevention actions and mindset for travelling and living in the country/ territory; • Potential diseases and its necessary vaccinations.
VI. Governing Law: Any disputes arising pursuant or related to this Statement of Understanding and/or to an EP’s participation in the Exchange Program shall be governed by the laws of the state of New York. The EP agrees that any such claims shall be brought only in the Supreme Court of the State of New York, New York County or the United States District AIESEC United States Exchange Participant Policies; Statement of Understanding
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  Court for the Southern District of New York.
VII. Signature Full name: Signature: Date: Witness:
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AIESEC US EXCHANGE PROGRAM WAIVER Agreement for Assumption of Risk, Indemnification, Release I,__________________________ (print name), age_________, desire to participate voluntarily in the AIESEC US Exchange Program (the “Exchange Program”). I UNDERSTAND THAT I AM BEING ASKED TO READ EACH OF THE FOLLOWING PARAGRAPHS CAREFULLY. Assumption of Risks: I acknowledge that I am voluntarily participating in the Exchange Program and am aware of the risks associated with traveling abroad. Nonetheless, I agree to assume all related risks, both known or unknown to me, of my participation in the Exchange Program and travel abroad, including but not limited to accidents, illness, civil strife, terrorism, and any other harm, injury, illness or damage which may befall me. I have been advised to review all travel warnings and advisories for the country of my TN prior to my departure. I agree to hold AIESEC US, AIESEC International and all AIESEC Local Chapters (the “Releasees”) harmless from any and all claims, including, but not limited to, claims relating to any injuries or illnesses I may suffer and any damage to or theft of my personal property, that may occur as a result of my participation in the Exchange Program, including travel to and from abroad. If AIESEC US, AIESEC International or any Local Chapter incurs any of these types of expenses, I agree to reimburse AIESEC US, AIESEC International the Local Chapter, as the case may be. If I need medical treatment while abroad, I agree to be financially responsible for any costs incurred as a result of such treatment. I acknowledge that I have been advised to have health insurance in effect prior to travelling and that no such coverage is provided for me by AIESEC US. I know, understand, and appreciate the risks that are inherent in the travel to foreign countries. I hereby assert that my participation in the Exchange Program is voluntary and that I knowingly assume all such risks.
Signature: ______________________________________ Print Name: _____________________________________ Date:_____________________________ If Under age 18: Parent Signature: ______________________________________ Print Name: _____________________________________ Date:_____________________________
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Hold Harmless, Indemnity and Release: In consideration of my participation in the Exchange Program, I agree to defend, hold harmless, indemnify and release the Releasees and their officers, employees, agents, and volunteers from and against any and all claims, demands, actions, or causes of action of any sort on account of damage to personal property, personal injury, or death which may result from my participation in the Exchange Program. This release includes claims based on the negligence of the Releasees, and their officers, employees, agents, and volunteers. I understand that by agreeing to this clause I am releasing claims and giving up substantial rights, including my right to sue.
Signature: ______________________________________ Print Name: _____________________________________ Date:_____________________________ If Under age 18: Parent Signature: ______________________________________ Print Name: _____________________________________ Date:_____________________________
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