2022 Career Institute

STUDENT APPLICATION - limited space, sign up early!

2022 Career Institute!
July 19th & 20th | 8:00am - 3:30pm

• The 2022 Career Institute will be held at the Orrin S. Estebo Career Development & Training Center located in the Redwood Valley High School in Redwood Falls, MN. This event is for students who will be going into grades 7-12 and is free to attend.
• This year's career explorations include Construction, Plumbing, Electrical, Graphic Design/Marketing, Photography, Medical Lab Tech, Powerline Tech, EMT/Paramedic, Livestock Production, IT, Agriculture, Drones, Cosmetology, Mechanical/Transportation, Early Childhood Development, and Law Enforcement. At the Career Institute you can expect hands on learning through interactive activities.
• When submitting an application, please keep in mind that the number of participants is limited. Applicants are asked to email info@prairiecareers.com or call Whitney Wills at 507-249-3196 if they are no longer able to attend after registering, this will give other students the opportunity to attend.
• Acceptance to the program is determined by grade level and the date the application is received.
• Students that attend both days will be entered for a chance to win a grand prize!

Student Personal Information

Full Name

Mailing Address

City, State, Zip

Birth Date

Primary Phone #

Email

Gender
MaleFemale
Grade Going Into

School Name
Red RockWestbrook Walnut GroveWabassoRedwoodSpringfieldCedar MountainRenville County WestOther, please specify below
Shirt Size
SmallMediumLargeXL2XL3XL
Is there a friend(s) whose group you would like to be placed in?

Parent/Guardian Information

First & Last Name

Daytime/Work Phone #

Cell Phone #

Email

Emergency Contact

Please list someone other than the parent/guardian from above.

First & Last Name

Primary Phone #

Health & Special Needs

• List allergies, their reaction, and how to manage them
• List any restrictions to activity
• Explain anything about your child that our staff may need to be aware of

WAIVER

1. I hereby certify that I am, or in the event, I am registering my minor child, my child is in normal health and capable of participating in the Technology and Trades on the Prairie Career Institute.
2. In the event of injury to my minor child, as a parent or legal guardian, I authorize a licensed physician to examine my child and in the event of injury to render such emergency care as he or she deems necessary for the treatment of such injury, including consultation and treatment by a specialist, including a surgeon. As a parent or legal guardian, I authorize Technology & Trades on the Prairie to send my minor child to the hospital or doctor most accessible.

PHOTOGRAPH & VIDEO RELEASE POLICY

Photographs or video may be taken at the Technology & Trades on the Prairie Career Institute, including photographs of your child(ren). Some of these photographs may be used in printed materials and/or on our official website or our sponsored social-media website on the internet to promote future events sponsored by Technology & Trades on the Prairie. In the event a photograph or video is used for these purposes, every effort will be made to protect the individual identity of all individuals depicted in the picture or video. No names, telephone numbers, addresses or other identifying information will be placed in the printed materials or on the internet. For these reasons, we are asking for your permission to use your/your child's photographs in our materials and on our website. By signing, I hereby grant Technology & Trades on the Prairie permission to use photographs, video and/or other images of my child(ren) for the purposes outlined above.

PRIVACY ADVISORY

The information you provide, including your name, address, telephone number, and any other identifying information, is classified by state law as private and is not accessible by the public but is accessible by you, or in the case of a minor is accessible by a parent or guardian or an individual acting as a parent or guardian in the absence of a parent or guardian, except that Technology & Trades on the Prairie shall withhold data from parents or guardians, or individuals acting as parents or guardians in the absence of parents or guardians, upon request by the minor if Technology & Trades on the Prairie determines that withholding the data would be in the best interest of the minor. We need this information to enroll you in the program and to be able to contact you if necessary. If you do not provide the information, you will not be enrolled in the requested program.
Technology & Trades on the Prairie shall not be liable for any claims, demands, injuries, damages, or actions whatsoever to the attendee or the attendee ’s property arising out of or connected with the use of any services and facilities of Orrin S. Estebo Career Development and Training Center located at the Redwood Valley High School. Attendee does forever release and discharge Technology & Trades on the Prairie shall from all such claims, demands, injuries, damages or actions; and from all acts of active or passive negligence on the part of Technology & Trades on the Prairies, it’s agents or employees.

I read the foregoing and certify my agreement by the checkbox and my online signature below.

Student Signature

Parent/Guardian Signature

Date

Upon submission, you should receive an email confirming your application has been received - if you do not receive an email please contact info@prairiecareers.com.