Tarrant County College Northeast Campus Community & Industry Education Services

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Tarrant County College Northeast Campus Community & Industry Education Services Explore and discover, your future awaits Community & Industry Education Services 828 W. Harwood Road Hurst, TX 76054-3299 Phone: 817-515-6500 Fax: 817-515-0683 www.tccd.edu

Summer Youth Camps Camp Orientations The responsibilities of college life are covered at orientation. In Person Orientation Campus maps and other information will be distributed during orientation. PUBLIC SERVICES / BUSINESS & INDUSTRY / ART & HUMANITIES / CHOIR / STEM / PHOTOGRAPHY Date: Tuesday, May 30 Date: Tuesday, May 30 OR Time: Noon 1 p.m. Time: 6 7 p.m. Location: TCC Northeast Campus, Larry J. Darlage Center Corner, NSTU 1615A Eligibility: Registration begins April 4. You may register online, in person, by mail or fax. Additional forms available on TCC website, www.tccd.edu. Registration begins at 8 a.m. Ensure that you have submitted all necessary documents to the Community & Industry Education Office: Application, orientation form, minor health form and copy of the student s latest report card (Progress Reports not accepted). If the above documents are not received in a timely manner, the student s application process will not be completed, thus a grant of petition will not be issued and the student will not be allowed to register. If you have questions about the application process, please call NE Community & Industry Education Office at 817-515-6500. Required Documents: Orientation policy agreement Summer camp application Health service form Informed consent form (field trips) Student s current report card Online Registration wa.tccd.edu

Ages: Students entering grades 6 9 Dates: June 5 8, 2017 Days: Monday Thursday Time: 8 a.m. 5 p.m. Cost: $140 Registration: Begins April 4, 2017 STEM Endorsement Camp Explore the area of STEM, activities will be completed to educate the students on degrees, certificates, and careers offered in the field. This course will have a day dedicated to Astronomy, and will explore the solar system using a planetarium dome. Students will also explore the areas of 3D printing, utilizing Solid Works software. The students will finish camp with a visit to the Perot Museum. Public Services Endorsement Camp Ages: Students entering grades 6 9 Dates: June 12 15, 2017 Days: Monday Thursday Time: 8 a.m. 5 p.m. Cost: $140 Registration: Begins April 4, 2017 Explore the area of Public Services, activities will be completed to educate the students on degrees, certificates, and careers offered in the field. Several areas will be covered: Education, Health Services, Paralegal, Government/Law, Fire Technology, and Human Services. Students will take a field trip to Tarrant County College, Trinity River Campus East, to explore the Center for Healthcare Professionals. As well as visit Tarrant County College-Northwest Campus to take a tour of the Criminal Justice Department and the Fire Service Training Center.

Business & Industry Endorsement Camp Ages: Students entering grades 6 9 Dates: June 19 22, 2017 Days: Monday Thursday Time: 8 a.m. 5 p.m. Cost: $140 Registration: Begins April 4, 2017 Explore the area of Business & Industry, activities will be completed to educate the students on degrees, certificates, and careers offered in the field. Students will become familiar with the 3D printer, take a tour and work in TCC s Radio and Television lab, and will have a guest speaker talk about the water park industry. The camp will conclude with a field trip to NRH20! Arts & Humanities Endorsement Camp Ages: Students entering grades 6 9 Dates: June 26 29, 2017 Days: Monday Thursday Time: 8 a.m. 5 p.m. Cost: $140 Registration: Begins April 4, 2017 Explore the area of Arts and Humanities, activities will be completed to educate the students on degrees, certificates, and careers offered in the field of dance, music, art, and theatre. A field trip to the Artisan will also take place. This is the camp to let your creative energies flow!

Ages: Students entering grades 9 12 Dates: July 31 August 3, 2017 Days: Monday Thursday Time: 10:30 a.m. 5 p.m. Cost: $100 Registration: Begins April 4, 2017 Choir Camp This course is designed for the high school student and director who wishes to learn the TMEA All State Choir music for district, region, and area tryouts. The course entails intensive rehearsals in sections and full choir. It is usually done for several hours each day for one week in the summer. The fee includes copies of the music. Digital Photography Camp Ages: Students entering grades 9 12 Dates: June 5 15, 2017 Days: Monday Thursday Time: 1 5 p.m. Cost: $140 Registration: Begins April 4, 2017 Explore the field of digital photography. Use your cell phone to create the best selfie; learn special techniques like aperture, shutter speed, and ISO. Software such as Photoshop and Adobe Bridge will be utilized to enhance student photos. Includes end of camp exhibit. Students may utilize their own personal digital camera or one will be provided to use during camp time.

Ages: Students entering grades 9 12 Dates: July 10 20, 2017 Days: Monday Thursday Time: 1 5 p.m. Cost: $140 Registration: Begins April 4, 2017 Photography Camp Explore the power of pictures. Create a project utilizing a Holga Camera; work with light to create a photogram; develop film in the darkroom. Includes trip to the Amon Carter museum and end of camp exhibit.

Summer Camp 2017 2010 Orientation Form Community & Industry Education Services This form must be turned in prior to registration. Once this form is approved and processed you may register any time starting April 4, 2017. Note: Without this signed form on file, the student will not receive T-shirt, giveaways, or be allowed to participate in the program. Contact Phone Number Northeast Campus 817-515-6500 817-515-0683 (fax) Online Registration available wa.tccd.edu This form is to acknowledge that I have reviewed policies and procedures in the 2017 Orientation packet. The orientation packet contains the policies, procedures and other pertinent information of the program. By signing this form I acknowledge that I will take responsibility for my child complying with appropriate College student behavior guidelines and other rules and regulations of the program. Failure to do so will result in my child not being allowed to participate in Summer Camp 2017. Please complete this form for each child, sign and return in person or fax to the Office of Community & Industry Education Services on the campus your child will be attending. Policies please place an X in each box. I have read and agree with the dismissal policy. I have read and agree with the discipline policy. I have read and agree with the procedure for refunds/fees. I have read and agree with the procedure for registration. I have read and agree with the procedure for Student ID Cards. I have read and agree with the payment policy. List name of the child enrolled: Student Name Grade Parent or Legal Guardian completing form Relationship to child Email address of Parent or Legal Guardian completing form Signature indicates acknowledgement and acceptance of Summer Camp policies and procedures in the 2017 Orientation packet. Signature of Parent or Legal Guardian Date

Summer Camp 2017 2010 This form must be turned in prior to registration. The application process cannot be completed until all forms are received by the Office of Community & Industry Education Services. Once this form is approved and processed you may register any time starting April 4, 2017. Assigned ID number or Student Social Security Number Date of Birth Application Form Gender Male Female Last Name First MI Online Registration available at: wa.tccd.edu Ethnic Group: Are you Hispanic or Latino? yes no 01 q White 02 q Black or African-American 03 q American-Indian or Alaskan Native 04 q Asian 05 q Native Hawaiian or Pacific Islander 06 q International 07 q Race Unknown Address City State Zip Home Phone Other Phone School District School attended 2016/2017 College for Kids 2017 forms submitted q YES q NO Grade entering Authorization Release 1. I approve of my child s enrollment in the checked Summer Camp. 2. I understand photographs of my child may be taken during participation in program activities and that they may be used in future College publications. 3. I authorize the administration of medical attention by TCCD personnel. 4. I authorize TCC to allow the following persons to call or come for my child in case of emergency or early dismissal. Person must call and inform the Office of Community & Industry Education Services of child s early dismissal. Person must pick up child from the Office of Community & Industry Education Services or the Nurse s office. Person must show TCCD personnel a picture ID for proper identification. I authorize TCC to allow the following persons to call or come for my child in case of an emergency or early dismissal. Name Relationship Telephone Parent or Legal Guardian Signature Relationship to Child Date

Summer Camp 2017 Registration Form Assigned ID number or Student Social Security Number Online Registration available wa.tccd.edu Last name First name MI Place an X on line beside each camp you wish to enroll. Term # Synonym # Course Section Title Start Date End Date Days Time Cost 2017Q4 0428225 GENX-1069-26292 Public Services Endorsement Camp June 12 June 15 MTWTh 8 a.m.-5 p.m. $140 2017Q4 0428232 BUAX-1033-26294 Business & Industry Endorsement Camp June 19 June 22 MTWTh 8 a.m.-5 p.m. $140 2017Q4 0428235 ARTX-1008-26296 Arts & Humanities Endorsement Camp June 26 June 29 MTWTh 8 a.m.-5 p.m. $140 2017Q4 0428236 MUSX-3220-26298 Choir Camp July 31 August 3 MTWTh 10:30 a.m.-5 p.m. $100 2017Q4 0428238 GENX-1072-26300 STEM Endorsement Camp June 5 June 8 MTWTh 8 a.m.-5 p.m. $140 2017Q4 0429870 PHTX-1520-26308 Digital Photography Camp June 5 June 15 MTWTh 1-5 p.m. $140 2017Q4 0429871 PHTX-1640-26310 Photography Camp July 10 July 20 MTWTh 1-5 p.m. $140 credit card authorization METHOD OF PAYMENT CASH CHECK CREDIT IF PAYING BY CREDIT CARD, PLEASE FILL IN AUTHORIZATION BELOW AND INCLUDE WITH YOUR REGISTRATION. I AUTHORIZE TCC TO CHARGE TUITION AND FEES FOR THE ABOVE STUDENT: AMOUNT OF CHARGE $ TYPE OF CARD card # EXPIRATION DATE Sign name as on credit card REFUND POLICY Refunds are available to students who make their request in person at the Office of the Registrar. A 100 percent refund is allowed if the student is dropped the day before the program starts. An 80 percent refund is allowed if the student is dropped prior to the start of the second class meeting. All refunds take approximately four to six weeks to be processed and mailed. GS:CG.1/17

Consent to Emergency Treatment for Minor Student Name: DOB: Date: Campus: Student ID: Parent/guardian: Home #: Cell #: Work #: Parent/guardian: Home #: Cell #: Work #: In case of an emergency and parents cannot be reached, who should be contacted? 1. Name : Relationship to Student: Home #: Cell #: Work #: 2. Name : Relationship to Student: Home #: Cell #: Work #: Physician: Phone #: Preferred Hospital: Phone #: Consent to Emergency Treatment Tarrant County College District is an educational institution in which, a student, at the College has received written authorization to consent to emergency medical treatment from a person having the right to consent as follows: I,, the [relationship to student] grant Tarrant County College permission to authorize emergency medical treatment to the above named student in the event that the College is unable to contact me. This authorization shall remain in effect until revoked by me in writing and delivered to TCCD. The undersigned is responsible for all medical costs associated with this authorization. Furthermore, no liability is attached to either TCCD or any of its members and staff for such action. Signature of Parent or Legal Guardian Date Minor Student Health Information Allergic to (meds, food, insects, etc.): Type of reaction (rash, difficulty breathing, etc.): Current medical diagnoses or disabilities: Past injuries/illnesses/hospitalizations/surgeries: List any medications currently taking below. Health Services Form Medications Strength Dose Time Given:

828 W. Harwood Road Hurst, TX 76054-3299 Ph: 817-515-6500 Fax: 817-515-0683 www.tccd.edu Community & Industry Education Services An Equal Opportunity Institution/Equal Access to persons with disabilities. CIE:20-26332-1-17-cmg