Teen Girls Teen Girls Robotics Robotics Robotics Summer Camps

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					                                       Teen Girls Robotics
                                        Summer Camps

Dear Parent/Guardian:

Thank you for your interest and for your anticipated enrollment in our Teen Girls Robotics Camp at Northwest
Vista College. Teen Girls Robotics Camp will provide San Antonio’s children currently in high school grades
(ages 14 & up) with fun, interactive and hands-on experience with designing and building robots. This program
will serve as an early intervention that will inspire children to become astronauts, engineers, and scientists.
Teen Girls Robotics camp will also provide awareness of local high technology industries, educational
requirements for high paying jobs, local high technology history, available educational support programs
(grants, scholarships, Academies, etc.) and opportunities for transdisciplinary learning.

While attending the Northwest Vista College Teen Girls Robotics Camp, students will be expected to conduct
themselves as model participants. Please review the attached material for details.

Once you have determined that our offerings meet your needs, you may submit a complete registration packet.
Please note that the following forms must be submitted to April Padron in Pecan Hall Room 102D as soon as
possible. You may email, fax, send through regular mail or bring it in to our office.

Aside    from   the   registration forms,         we   encourage     you    to     also     register        online   at .

For further registration instructions please refer to the Teen Girls Robotics Registration and Information sheet

If you have any questions regarding the program guidelines and regulations, you may contact us at (210) 486-

You and your child are about to embark upon a new and innovative program that will encourage lifelong
learning in the fields of Math and Sciences.

We welcome and congratulate all students who are about to embark on this journey!

Andrew Schuetze, Director
TIER (Texas Institute for Educational Robotics)

Registration Packet
    SpaceTEAMS Robotics Description and Agenda
    SpaceTEAMS Robotics Registration and Payment Information                         Andrew Schuetze
    Northwest Vista College Campus Map                                 3535 N. Ellison Dr. Pecan Hall 102
    SpaceTEAMS Robotics Behavior Agreement                                  San Antonio, TX 78251-4217
    SpaceTEAMS Robotics Emergency Contact and Medical Information                           210.486-4430
    SpaceTEAMS Robotics Registration Form                                              210.486-4420FAX
    SpaceTEAMS Robotics Photo Release Form
    SpaceTEAMS Robotics Indemnification agreement
    Registration Packet Check-List
                     Teen Girls Robotics Camp Information
 This course packet provides the information required to complete the Teen Girls Robotics
 Camp registration form included in the packet.
             All students must meet age/grade requirements.
             Parent/guardian must sign the registration forms.
             There is no fee for the high school camp

 Final enrollment is determined by the Texas Institute for Educational Robotics and you will
 receive notification of enrollment status before the start of camp.

 Description of Camp: Participants will also learn to program autonomous function in their
 robots using a text-based computer interface, the RobotC software and the Tetrix robot kit
 system. Groups of our campers will comprise a team and move through the camp experience
 and construct one robot to use in mini-challenges as well as the final exhibition. Parents,
 grandparents, and friends are encouraged to attend the exhibition and closing ceremonies.

 Lunch will be provided. If your student has any special dietary needs please contact, Andrew
 Schuetze, TIER director and discuss the specific needs.

 Complete Registration Packet and submit

        All students must have a completed registration packet turned in to the
        TIER office prior to camp start date.
        -Submit by Mail or bring to TIER office:
        Northwest Vista College
        Teen Girls Robotics Summer Camp
        3535 N. Ellison Dr., Box 19
        San Antonio, TX 78251

        TIER office is located in Pecan Hall, room 102D. Ask for April Padron.

        -Submit by Fax:
        Complete and fax the registration forms to:
        ATTN: April Padron, Teen Girls Robotics Camp
        FAX Number: 210.486.4420

        -Submit by Email:

Withdrawal Policy:
Parents must officially withdraw students via fax, mail, or in person. Withdrawal requests require
student identification number, name, course title, parent/guardian’s signature, and date.
                Teen Girls Robotics Camp at the
                 Northwest Vista College (NVC)
                               Teen Girls Robotics
                            August 3 – 14, 2009 at NVC
       Date             Time                  Activity               Room
      Week 1
                     9:00 AM –
          Mon                            Student Orientation          TBA
                     9:00 AM –
          Tue                             History of Robotics         TBA
                     9:00 AM –
          Wed                            Lecture & Hands-On           TBA
                     9:00 AM –
          Thu                            Lecture & Hands-On           TBA
                     9:00 AM –
          Fri                            Lecture & Hands-On           TBA
      Week 2
                     9:00 AM –
          Mon                            Lecture & Hands-On           TBA
                     9:00 AM –
          Tue                                 Hands-On                TBA
                     9:00 AM –
          Wed                        Final Day to complete Robots     TBA
                     9:00 AM –
          Thu                             Elementary demo             TBA
                     9:00 AM –
          Fri                        Closing Ceremony & Awards

                                Daily Schedule
                         Monday-Friday 9:00am-3:00pm
                 Time                        Activity               Location
                                   Student Arrival & Student Roll
           9:00 AM-9:15 AM                                            TBA
          9:15 AM -11:00 AM              Lecture Session              TBA
          11:00 AM -11:45 AM                   Lunch                  TBA
          11:45 AM -3:00 PM             Workshop Session              TBA
       Northwest Vista College Campus Map
                               3535 N. Ellison Dr.
                             San Antonio, TX 78251

Texas Institute for Education Robotics (TIER) Office located in Pecan Hall
                                                                                                                                               Office Use Only
                  Teen Girls Robotics Camp
                         Northwest Vista College                                                                                                Semester/Term
          3535 N. Ellison Drive, Box19, San Antonio, TX 78251
          Telephone No.: 210-486-4421 FAX No.: 210-486-4420
                     Email:                                                                                             Processed By/Date


               /               /                                                                          Date of Birth:                /          /
Student Social Security Number or                                                                                              Month         Day         Year
NVC Assigned Student ID Number

Student Last Name                                                 First Name                                                                    Middle Initial

Parent/Guardian Last Name                          Parent/Guardian First Name

Street Address                                               City                                         State                      Zip           County

Primary Telephone (Area Code and Number)                                         Secondary Telephone (Area Code and Number)

Primary E-mail Address                                                           Secondary E-mail Address

2008-2009 school year grade level. __9th __ 10th __ 11th __12th (Must be 14 years old or over) Girl Scout member __ Yes __ No

                              Optional Reporting Data                                                            Bacterial Meningitis Information:
                                                                                   This information is being provided to all new college students in the state of Texas. Bacterial
   Responses are kept confidential; used for federal/state reporting purposes.     Meningitis is a serious, potentially deadly disease that can progress extremely fast – so take
                                                                                   utmost caution. It is an inflammation of the membranes that surround the brain and spinal
Gender:            □ Female      □ Male                                            cord. The bacteria that cause meningitis can also infect the blood. This disease strikes
                                                                                   about 3,000 Americans each year, including 100-125 on college campuses, leading to 5-15
Marital Status:   □ Single       □ Married       □ Divorced       □   Widowed      deaths among college students every year. There is a treatment, but those who survive may
                                                                                   develop severe health problems or disabilities. Additional information will be provided with
Ethnicity:        □ White/Non-Hispanic -1         □ Black Non-Hispanic-2           the admissions application when you register. How can I find out more information?
                                                                                   • Contact your own health care provider.
 □ Hispanic-3     □ Asian/Pacific Islander -4     □ American Indian/Alaskan-5      • Contact your local or regional Texas Department of Health at 210- 207-8804
                                                                                   • Contact web sites:;
 Are you a Texas Resident? ________ if yes, how many years? _________

                                    NORTHWEST VISTA COLLEGE SPECIAL SERVICES OFFICE AT 210-486-4449.

   Course # /                                                                                                                                                     Cost Per
                                          Course Title / Call #                           Days                  Start Date                  End Date
   Section #                                                                                                                                                      Student

SPTR3000.411                            Teen Girls / #10062                           Mon – Fri                 8/03/09                     8/14/09                 $0.00

                                         I hereby certify that the above information is true, complete, and accurate.

                                                   Student Signature or Parent Signature for Minor                                                             Date
                                SpaceTEAMS Behavior Agreement

It is very important that students and parents/guardians understand the expectations held by
Northwest Vista College.

While attending the SpaceTEAMS program, students will conduct themselves as “model participants.”

Please, review the following rules with your child:
    • No drugs/medications can be administered by Northwest Vista College
    • All prescription medications should be reported to the program coordinator and administered
        by the parent/guardian; otherwise, no medications or drugs are allowed.
    • Show respect for individuals and their property.
    • Use “inside voices” when inside the campus buildings
    • Food and drink including gum and candy is allowed only during breaks.
    • No weapons are allowed on the Northwest Vista College campus.
    • Altering campus property (defacing, damaging, etc.) is also prohibited.
    • No disruptive behavior is will be permitted. Parents/guardians will receive immediate parent
        notification of their child’s behavior. A second notice will constitute expulsion from the
    • Please identify special needs (physical disability, learning disability, ADHD, ADD, Emotional
        disorder, etc.) on SpaceTEAMS Robotics Program Assessment and notify Andrew Schuetze,
        Director of TIER, at 210-486-4430.

Northwest Vista College staff will make every effort to assure that classes and events take place at
their scheduled locations and times.

   •   Participant supervision is NOT available outside the programmed times and

I have read and fully understand the SpaceTEAMS Robotics Behavioral Agreement. I understand
that as a SpaceTEAMS Robotics Summer Program parent/guardian and participant, we are required
to adhere to these rules and all pertinent rules and guidelines that are deemed necessary by the
college administration for the duration of the program and while on the Northwest Vista College
campus locations.

I agree to thoroughly discuss these rules with
                                                         (Child’s Full Name)
to ensure understanding and compliance. I understand that non-compliance can constitute
immediate dismissal from the program without entitlement to tuition/fees refunds.

Parent/Guardian Signature:                                          Date

                     Submit completed form to April Padron in Pecan Hall 102D.
                                    Emergency Contact and Medical Information

All prescription medication should be reported to the program coordinator. No drugs or medication are allowed
or administered by Northwest Vista College representatives. Medications are to be administered only by the
participant’s parent/guardian.

Participant Name:
                                          Last                                  First   MI

Parent(s)/Guardian(s) Name:
                                          Last                                  First   MI

Daytime Phone Number:                     (        )

Emergency Contact(s):

                                                                         (     )
Last                              First                                  Daytime Telephone

                                                                         (     )
Last                              First                                  Daytime Telephone

Who has been designated to pick up the participant(s) each day?

Relationship to Participant               Last Name, First Name                 Daytime Tel.No.

Relationship to Participant               Last Name, First Name                 Daytime Tel.No.

List ALLERGIES:                                                   List MEDICATION:

Is the student under any medications?
______ Yes- List them here: _________________________________________________________________
______ No

How often does your child take medication?
______ Daily (Monday – Friday)   ______ Weekly                    ______ No medication taken

Additional pertinent information regarding your participant’s learning/emotional/physical needs below.

                              Submit completed form to Andrew Schuetze, Director of TIER, PH 102D
                                    prior to the first class day to ensure program participation.
                        Release and Indemnification Agreement Letter

Northwest Vista College, one of the Alamo Colleges, is pleased to be able to provide the children in the
community with challenging, creative, safe and fun activities during the summer weeks. We strive to make their
time with us not only enjoyable, but safe.
As parents and guardians of these children, Alamo Colleges feels you should be fully informed of the conditions
under which your children are visiting our campuses.
Under the Texas Tort Claims Act, Northwest Vista College is a political subdivision of the State of Texas.
Under this Act, Alamo Colleges is not responsible or liable to any person for property damage, personal injury
or death. The only exception to the above involves an ACCD-owned vehicle. Under the Act, the damages
Alamo Colleges may be held responsible for are limited for property damage, personal injury or death caused
by a District-owned vehicle.
Several of our campuses have Student Health Centers, which will be open during the Summer Program and are
staffed by trained personnel. However, no treatment, other than in a life threatening event, may be provided
without a signed release from the parent or guardian.

The attached Release and Indemnification Agreement is mandatory for your child’s participation in
SpaceTEAMS Robotics Summer Program. This Agreement will allow our campus faculty and staff to provide
emergency and/or minor medical care for injuries or illnesses, which may occur while your child is participating
in our SpaceTEAMS Robotics Summer Program.
Signed Releases must be returned prior to the start of the program to allow your child’s participation.
Please be assured that every effort has been made to provide your child with a healthy, safe, “kid friendly”
environment in which to enjoy these year round programs.
Should you have any questions, please call (210) 486-4421.

Participant Name and Date

Parent / Guardian Signature and Date
                                    Release and Indemnification Agreement

                                                  (Name of Child)

The undersigned representative, on behalf of the child named above (herein after “the child”), who desires to participate in
the SpaceTEAMS Summer Program, and in consideration of being permitted to participate in said activity, voluntarily and
knowingly executes this release and indemnity agreement on behalf of the child with the express intention of
extinguishing the rights and obligations designated herein. The undersigned representative, on behalf of the child, hereby
grants the Campus Nurse(s) of the Alamo Colleges, the permission to provide treatment for emergency and/or minor
medical injuries or illnesses, which may arise while the child is participating in a SpaceTEAMS Robotics activity.

As representative of the child, I hereby elect to and assume all risks for claims hereinafter arising, known or unknown,
from the conduct of the SpaceTEAMS Robotics Summer Program and hereby knowingly and voluntarily expressly
release the Alamo Colleges, its employees, agents, representatives, officers, directors or others acting on behalf of Alamo
Colleges, from all liability for claims arising out of such matters.

With the intention of binding the child and with full authority to do so, I hereby release, discharge and indemnify the
Alamo Colleges, its employees, agents, representatives, officers, directors or other acting on behalf of Alamo Colleges,
from any and all claims, demands, actions, judgments and executions which the child ever had, or now has, or ever will
have, or which the child may claim to have against Alamo Colleges, its employees, agents, representatives, officers,
directors or others acting on behalf of Alamo Colleges, in connection with or arising out of, directly or indirectly, any and
all matters relating to the SpaceTEAMS Summer Program, including any alleged acts of negligence by Alamo Colleges’
employees, agents, representatives, officers, directors or others acting on behalf of Alamo Colleges.

As the duly authorized agent of the child, I have read this release and indemnification and understand all of its terms.
This release and indemnification agreement is executed voluntarily and with full knowledge of its contents and

                                          _______________________________________ ____
Date                                       Duly Authorized Representative for the Child

                                             Print Name Here
Issued 5/19/2008
                                              Photo Release Form

       I allow the Public Relations office at Northwest Vista College and its photography consultants,
contractors, full-time and part-time employees to take photographs of my child ______________________.
                                                                                     (Print child’s name)

       Further, I hereby release and otherwise agree to hold Northwest Vista College and its employees
harmless from any and all claims arising out of, or resulting from, my child’s appearance in the above
       I further understand that I have the right to revoke this permission to Northwest Vista College at any
time. This will only apply to future marketing, advertising and public relations pieces, not those already in
existence. If I choose to revoke these rights, I must do so in writing and the document must include my

   These photos will be used for marketing, advertising and public relations purposes and may appear in
   brochures, newspapers, magazines, buses, movie theaters, other such marketing pieces, or in the
   photographer’s portfolio. I agree that I will not receive any pay or reimbursement for these photographs.

Name of Child

_________________________                                    _______________________
Name of Parent                                               Signature

   Registration Completion Check-List

Completed SpaceTEAMS Behavior Agreement

Completed Emergency Contact and Medical Information

Completed Registration Form

Signed Release and Indemnification Agreement Letter

Signed Release and Indemnification Agreement

Signed Photo Release Form

Submitted Registration Packet (all six forms) to TIER

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