Construction Career Days - the Construction Pro Rodeo

CONSTRUCTION CAREER DAYS
REGISTRATION FORM
May 4-5, 2016
8 am - 1 pm
New Life Church (former Mountainside Resort)
350 High Hill Road, Wallingford
Construction Career Days are back! Join us for the 5th Annual Construction Career Days for the most
hands-on, innovative and exciting two-day student expo in the area. Students can OPERATE a skid steer,
excavator and crane simulator; CLIMB a United Illuminating utility pole; BUILD a masonry wall; CUT tile;
REV a Chevy engine; JACK HAMMER; SOLDER; USE a variety of power tools#and more! Now is the
time to expose today’s students to tomorrow’s careers in construction.
Date to attend (select one)
School Name/Company
Wednesday,
May 4, 2016
Thursday,
May 5, 2016
Contact Name
Will participate with __________ students at $10.00 per student
Address
Will participate with __________ teachers/chaperones/counselors at
$5.00 per person (minimum 1 adult per 10 students)
City
State
Zip
Billing Information
Phone
Email
Payment due by Fri., April 29th
Total Students x $10 =
P.O. No.
Total Chaperones x $5 =
Lunch: Students may bring their own lunch (we will provide a cafeteria
Total $
area and water). A food vendor will sell food and beverage on-site
Method of
Payment
Check
(Payable to: CT ABC)
Credit Card #
MasterCard
Visa
American Express
Exp. date
Billing Address
Name on card (please print)
Signature
Please reply to
Fax: (860) 529-6778
Email: [email protected]
Mail: 2138 Silas Deane Hwy, Suite 101, Rocky Hill, CT 06067
Discover
V Code
Construction Career Days
Wednesday and Thursday, May 4-5, 2016
PARENT/GUARDIAN CONSENT FORM
Your son or daughter has been invited to attend the Construction Career Day on Wednesday or Thursday, May 4th or 5th,
various trades in the Construction Industry. He or she will have the opportunity to operate an excavator and a skid steer as
well as handle tools used by carpenters, plumbers, electricians, sheet metal workers and HVAC Technicians. Such tools
include, but are not limited to saws, nail guns, etc. They will discuss a typical workday and explore different aspects of
working in the construction field with employers. They will learn what skills are necessary to enter this industry. In order
to participate, this form must be filled out and brought to the event. No student will be allowed to enter without a
consent form.
Permission to Participate in the CT Construction Career Day Event
My child, __________________________________, of ___________________________school may participate in the
Construction Career Day experience, which will take place at the New Life Church (former Mountainside Resort),
Wallingford, CT Campus, on Wednesday or Thursday, May 4th or 5th, 2016 between the hours of 8:00 a.m. and 1:00 p.m.
Dress appropriately. Most of the activities will take place outside. Long pants and comfortable walking shoes, construction
boots or heavy sneakers are a must. Sandals, open-toed shoes, shorts and capris are unacceptable.
I acknowledge that I have been informed as to the nature of the event. I understand that participation in these
activities is entirely voluntary and requires participants to abide by applicable rules and standards of conduct. In
consideration of my child being allowed to participate, I agree on behalf of myself, my child named herein, or our
heirs, successors and assigns, to release, hold harmless, indemnify and defend the Associated Builders & Contractors
of Connecticut, the Construction Education Center, their officers, directors and agents from any and all claims,
demands, damage, costs and expenses arising from or in connection with my child attending and participating in the
Construction Career Day Event. I further acknowledge that I have read the foregoing and understand its
significance, and that I have executed this document voluntarily.
Permission to travel to the Construction Career Day Site: I understand and give permission for my son/daughter,
_________________________________, to travel to the Construction Career Day under the supervision of school staff, and
participate in all activities, including participating in hands-on construction demonstrations.
______________________________________________
SIGNATURE OF PARENT OR GUARDIAN
________________________
DATE
Media Release
I understand that the Construction Career Day will attract media coverage. There is a possibility that children will be
photographed, videotaped, and/or quoted during the experience. I grant permission to photograph, videotape, and/or quote
my son or daughter, _____________________________________________, for promotional and educational purposes.
_____________________________
Parent Contact Number
_____________________________________________________
Emergency Contact Name/Number
______________________________________________
SIGNATURE OF PARENT OR GUARDIAN
________________________
DATE