Dear Talented and Gifted Student - Walters State Community College

DIVISION OF COMMUNITY EDUCATION
COMMUNITY SERVICE PROGRAMS
September 17, 2012
Dear Talented and Gifted Student:
Congratulations for being selected for the 2013 Talented and Gifted (T.A.G.) student program. You have been recognized
for your outstanding academic achievements. The T.A.G. program at Walters State Community College is in its 31st year
of providing special courses to select students from our 10 county service area. We are looking forward to seeing you here
in January and congratulate you on being selected.
This year, the T.A.G. 2013 Program is scheduled for each Saturday from January 12 through February 16, 2013. The makeup weekend will be February 23, 2013, if we have a bad weather condition on one of our weekends. This packet includes
a Registration/Student Preference Survey, Liability Waiver and Medical Release forms (provide all information requested
and sign in the three designated signature areas), Program Information Sheet, Program Schedule matrix, and Course Description. Be sure to review the entire packet. The following timeline and information has been established for this year’s
registration procedure:
1.Complete the Registration/Student Preference Survey Form referencing the Program Schedule matrix and Course
Descriptions. Please note that incomplete applications will not be processed and may prevent your child from getting their preferred choices.
2.Registration Fee is $209.00 (a $20 discount [$189.00] for each additional child in the same family).
3.Deadline is, is, November 20, 2012. Registrations, payment and all forms must be received in the Cashier’s Office
at Walters State Community College. Courses will be assigned to students as registrations are received. (Registrations submitted after the deadline will be processed on a space availability basis in the order received.)
4.Please include the Registration Fee, Registration/Student Preference Survey, and Waiver forms. These must all
be received together and signed; incomplete applications will not be processed. This may delay your child being
assigned in their course preferences.
5.
Schedule Packets will be mailed to the student’s registration address during the week of December 16, 2012.
Packets will include the following: Student Schedule, Inclement Weather Policy, and Cafeteria Menu/Price List.
Please contact the Division of Community Education at (423) 585-2675 or (423) 585-6756 if you have any questions or need
additional information. We look forward to seeing you on Saturday, January 12, 2013.
Sincerely,
Dr. Nicole Cardwell-Hampton Division of Community Education
Walters State Community College
500 S. Davy Crockett Parkway
Morristown, TN 37813-6899
423-585-2675, 423-585-6756
500 SOUTH DAVY CROCKETT PARKWAY ■ MORRISTOWN, TENNESSEE 37813-6899
Office: 423-585-2675 ■ Fax: 423-585-2679 ■ http://www.ws.ed/tag/
A Tennessee Board of Regents College
T.A.G. 2013
PROGRAM INFORMATION SHEET
The Talented and Gifted Program was initiated by Walters State Community College in April of 1982. The program’s inception was the result of a request by the
Superintendent of Cocke County Schools proposing that Walters State Community
College design an instructional program to provide enrichment activities geared
toward gifted students in the upper East Tennessee area.
Now in its 31st year, T.A.G. 2013 – with a projected enrollment of to 650 students
from 13 area public school systems, private schools and home school cooperatives
– consists of approximately 35 programs offered multiple times which have been
designed to stimulate and challenge East Tennessee’s gifted students from the fifth, sixth, seventh and eighth
grades. The classes are instructed by area experts and will be conducted in such a manner as to encourage student participation in hands-on activities, as well as verbal participation.
The staff of the Division of Community Education at Walters State Community College, along with T.A.G. 2013
faculty members, is pleased to have the opportunity to work with area educators in implementing and presenting this program on an annual basis.
Following is information pertinent to the 2013 program:
DATES:January 12 - February 16
DAY: Saturdays
TIME: 9:00 a.m. - 1:30 p.m.
LOCATION:
WSCC – Morristown Campus
DURATION:
6 weeks
COST:
$209 per student - 6 week program
(Includes: T.A.G. souvenir package and
classroom supplies)
PLEASE NOTE:
1. REGISTRATION DEADLINE - Send completed Registration/Student Preference Survey form with the Registration Fee to the Cashier’s Office at Walters State Community College by the deadline November 20, 2012. Classes will be assigned in the order received, subject to availability. The sooner you register the better
chance you will have for your first choice selections.
Checks or Money Orders should be made payable to Walters State. Also, Visa, Master Card and Discover are
accepted online; if you choose to pay by credit card, please refer to the “Payment Options for 2013 Talented
and Gifted” information sheet. (Registration forms received after the deadline will be considered in the order
received until the maximum number of student registrations is accepted.)
2. SCHEDULE PACKETS - Will be mailed to the student’s registration address during the week of December 16,
2012. Packets will include the following: Student Schedule, Inclement Weather Policy, and Cafeteria Menu/
Price List. If your schedule packet has not been received by January 7, 2013, you should contact our office,
423-585-2675.
3. TRANSPORTATION - The T.A.G. Coordinator at your school will provide students with information regarding
transportation arrangements, if offered, through your school system. If you have questions about transportation, please contact your child’s TAG coordinator. TRANSPORTATION IS NOT PROVIDED BY WALTERS STATE
COMMUNITY COLLEGE.
4. INCLEMENT WEATHER - Classes cancelled due to inclement weather will be made up in the manner announced
by staff of the Division of Community Education and will be posted on our website http://www.ws.edu 5. BACK BY POPULAR DEMAND! To celebrate your T.A.G. registration, each student will receive a souvenir package. These souvenir packages will be handed out during class time the second session.
TALENTED AND GIFTED (T.A.G.)
STUDENT REGISTRATION FORM & PREFERENCE SURVEY
STUDENT INFORMATION (Information requested for person registering for the class)
*** For Reporting Purposes Only
Social Security Number __________ - ______ - __________
(if U.S. Social Security number is not available, a student I.D. will be assigned)
Sex ❏ Male ❏ Female
Birthday __________ /__________ /__________
Race ❏ Asian/Pacific Islander ❏ Hispanic
month
Student Name
Home Address
Last
day
year
Citizenship ❏ U.S. Citizen ❏ Other ______________
❏ Black/Non-Hispanic
❏ Native American Indian
First
Street or RFD
City
County
State
❏ Alaskan Native
❏ White
Middle
Zip Code
Email Address
School Name
County of School
(Check One) ❏ City School System ❏ County School System
Grade (Check One) ❏ 5th ❏ 6th ❏ 7th ❏ 8th Name of School Coordinator
Parent/Legal Guardian Name
Last First Middle
Phone Numbers: Home Work Cell Relationship
Emergency
CEU #
TALENTED AND GIFTED STUDENT PROGRAM - 2013
AND
Course/Seminar Name TALENTED
GIFTED PROGRAM
2013 - MORRISTOWN
Course Location WSCC
Time 9:00
A.M. – 1:30 P.M. Day(s) SATURDAYS
Dates Jan. 12, 19, 26;
Feb. 2, 9, 16
Semester SPRING
00001
Fees $209 (Includes: tuition, registration fee & souvenirs) STUDENT PREFERENCE SURVEY
INSTRUCTIONS: Reference the Program Schedule matrix and select 3 courses from each session in order of preference; 9 different course titles in
all. Courses on the Program Schedule that are listed in more than one session will be considered when your schedule is made. * DO NOT DUPLICATE
COURSE TITLES. Your final schedule will reflect 3 classes. **
SESSION ONE
1. ____________________________________________________
2. ____________________________________________________
3. ____________________________________________________
SESSION THREE
1. ____________________________________________________
2. ____________________________________________________
3. ____________________________________________________ SESSION TWO
1. ____________________________________________________
2. ____________________________________________________
3. ____________________________________________________
**Preferences should be listed in order of student’s interest, keeping
in mind that the student may be enrolled in any of the courses listed,
based on availability and receipt of the application by deadline.
Note: Classes assigned on a first come basis. Incomplete registration forms will not be considered.
I certify that all information provided on this form is accurate. I am aware that this course is a “non-credit” course, and that continuing education units
may be awarded. I am aware there will be no refunds other than for cancellation of the class by the college. For extenuating circumstances this may
be appealed through the Dean of Community Education.
Parent (or Guardian) Signature
Date
FOR BUSINESS OFFICE USE ONLY
Date Fee $ Paid by Paid for Receipt No. ❏ Cash ❏ Check # ________ Receipted by (initials) _______
2013 TALENTED & GIFTED PROGRAM COURSE SCHEDULE
Please reference the courses listed below when completing the Student Preference Survey. Select 3 courses from each session in order of preference; each student will be enrolled into one course per session. SESSION ONE
JANUARY 12 & JANUARY 19
3-D, Nature, Animation Drawing
Acting for Beginners
Adventures with P.C.’s
A&P Pickled Pigs
Archaeology
Astronomy
AutoCAD with Project
Beginning German
Biology
Chemistry
Crime Scene Investigation
Digital Scrapbooking
Emergency 911
Engineering Mythbusters
Exploration of World Cultures
Fashion/Jewelry Design
Forensic Science
French
Fungus Among Us
Games Galore
Genealogy: Who are You?
Introduction to Watercolor
Let’s Fire It Up
Make It Magic
Marine Biology
Military History
Military Science
Movie Production
Ooey Gooey Shocking Science
Park Ranger Survival Skills
Physics
Pottery
Robot Wars
Sign Language - Level 1
Song Writing
So You Want to be an Engineer
So You Want to be a Lawyer
So You Want to be a Physical Therapist So You Want to be a Veterinarian
Weird Science
SESSION TWO
JANUARY 26 & FEBRUARY 2
3-D, Nature, Animation Drawing
Advanced Acting
Adventures with P.C.’s
A&P Pickled Pigs
Archaeology
Astronomy
AutoCAD with Project
Beginning German
Biology
Chemistry
Crime Scene Investigation
Digital Scrapbooking
Emergency 911
Fashion/Jewelry Design
Forensic Science
French
Fungus Among Us
Games Galore
Genealogy: Who are You?
Got Talent – Music?
Introduction to Watercolor
Let’s Fire It Up
Make it Magic
Marine Biology
Military History
Military Science
Movie Production
Ooey Gooey Shocking Science
Park Ranger Survival Skills
Physics
Pottery
Robot Wars
Sign Language – Level 1
Song Writing
So You Want to be an Engineer
So You Want to be a Lawyer
So You Want to be a Physical Therapist So You Want to be a Veterinarian
Weird Science
SESSION THREE
FEBRUARY 9 & FEBRUARY 16
3-D, Nature, Animation Drawing
Advanced Acting
Adventures with P.C.’s
A&P Pickled Pigs
Archaeology
Astronomy
AutoCAD with Project
Beginning German
Biology
Chemistry
Creative Writing
Crime Scene Investigation
Digital Scrapbooking
Emergency 911
Engineering Mythbusters
Fashion/Jewelry Design
Forensic Science
French
Fungus Among Us
Games Galore
Genealogy: Who are You?
Introduction to Watercolor
Let’s Fire It Up
Make it Magic
Marine Biology
Military History
Military Science
Movie Production
Ooey Gooey Shocking Science
Park Ranger Survival Skills
Physics
Pottery
Robot Wars
Sign Language – Level 1
Song Writing
So You Want to be an Engineer
So You Want to be a Lawyer
So You Want to be a Physical Therapist
So You Want to be a Veterinarian
Spanish
Weird Science
2013 TALENTED & GIFTED PROGRAM
Course Descriptions
Classes for 2013 (Alphabetical Order)
3-D, Nature, Animation Drawing – This course will be chalked full of fun. Students will have the opportunity to express themselves through 3-D drawing using one and two dimensional techniques while incorporating shading and shadows and the
breakdown of the face. The fun doesn’t stop there, how about some cartoon animation drawing, like the animators of Disney. Students will study the art of stop animation, animal images and fantasy drawing. Last but not least, students will try their
hands at drawing plants, people and animals.
Acting for Beginners – Students will learn the basics of acting techniques by working on one short monologue or scene. Class
size is deliberately restricted to allow for personal coaching. Students may provide their own monologue or select one from
the instructor’s files. Course includes staging, physical character interpretation and special concerns such as age, etc. Students
should wear casual clothing that permits free movement.
Advanced Acting– An expanded acting class for performers with some previous experience, it will explore the creation of character and character development, improvisational skills for humor and drama, script reading and ways to improve auditioning
and performing for a wide variety of roles.
Adventures with PC’s – Students will use the textbook Teach Yourself Visually – Windows XP to learn how to operate Windows
XP through launching programs, creating and editing documents, creating and working with images, playing music and other
media, working with files, sharing computers, connecting to the internet, and surfing the internet for school projects.
A&P Pickled Pigs (Anatomy & Physiology) – This course is designed to teach students how their bodies work by providing a
close look at body systems through the dissection of a fetal pig. The students will also have the opportunity to perform handson biochemical laboratory assignments to gain a better understanding of the metabolic functions or organisms.
Archaeology– Join in an adventure to uncover some of the mysteries of our past. In this class your will learn what archaeology
is and the basic skills used by archaeologists today. You will unearth information about Egyptian mummies and hieroglyphics;
as well as learn how people from the past lived based on the things (artifacts) they left behind. Put on your hard hats and get
out your trowel for a packed full class.
Astronomy – Did you know? Saturn is so lightweight that it could float on water if there was a sea large enough to hold it. This
course will explore the science of the sun, stars and moons and their magnitudes and motions.
AutoCAD with Project – Through basic drafting students will learn the fundamentals of using the popular software package
AutoCAD and will have the opportunity to utilize basic drawing tools to produce a classroom project.
Beginning German (NEW) - This course introduces students to basic spoken and written German. All of the four skills (listening,
speaking, writing, and reading) will be developed to a point to allow communication on an elementary level about everyday
topics. Geographical, historical, and cultural information will deepen students understanding of the German language and its
people. An individualized learning atmosphere as well as a strong group identity will be created to foster cooperation and learning support.
Biology – Emphasis in this course will be directed toward hands-on biology laboratory exercises. Microscope work will be performed as well as general dissection of specimens. Other experiments will be based on biological principles, which may include
digestion, respiration and enzyme activity.
Chemistry – The main emphasis of this course will be to heighten the awareness of the student to his or her chemical surroundings. The class will focus on a discussion of some fundamental chemical concepts and principles of chemistry, which affect each
of us in everyday happenings. Some of the areas of discussion will include pharmaceuticals, plastics, textiles and super conductors. The students will perform a number of exciting experiments in the laboratory and will have the opportunity to learn about
chemistry hands-on. In addition to the hands-on learning, the students will see several spectacular chemical demonstrations.
Creative Writing – This course will stimulate interest in writing character sketches, settings and poems such as haiku and
cinquein. Students will look at professional examples, videos and other student works as models for their own writing. At the
end of the session, students will produce a collection of their own writing with illustrations.
Crime Scene Investigation – Students will study and practice some of the basic skills and fundamentals in collecting evidence,
as it would relate to a crime scene in the role of detective, forensic scientist and lawyer. Excitement builds as students examine
clues, make a case and bring it to trial. This is an excellent course to relate how essential science and math are to the study of
forensic science.
Digital Scrapbooking – This use of technology is everywhere and the next step in scrapbooking is the use of technology. In this
course students will learn the art of preserving and capturing memories through the use of various technological programs.
Emergency 911 - Learning first aid and safety while having fun. Creating a hands-on learning environment on how students can
protect themselves inside and outside the home. What to do in an emergency, how to call for help, and how to access an AED. Students will also learn CPR training with manikins, how to stock a first aid kit and simple first aid.
Engineering Mythbusters – This class explores engineering concepts “just to see what happens.” Which type of racing car will
go the fastest? Why are different kinds of bridges safer? How does an electric circuit work? This course explores multiple fields
of engineering.
Exploration of World Cultures - Do you know what happens under a mandap? Can you use chopsticks? Have you ever danced
merengue? Come explore world cultures by diving into geography, religions, customs and food.
Fashion Design/Jewelry Design – Students will be exposed to the different aspects of jewelry design which consists of learning
the proper terms, tools and design techniques. This course will allow students to come up with a design concept and make that
concept come to left using the different beading techniques. Creativity is left to the student when they craft their own designs. Students will get a choice of two design projects to complete while in class. In addition, this class will include discussions on
research, history of fashion/costume, textiles, and cost-effectiveness of ideas, fabric suitability and market research.
Forensic Science – Forensic science (often shortened to forensics) is the application of a broad spectrum of sciences to answer
questions of interest to the legal system. This may be in relation to a crime or to a civil action. Students will learn how to use a
broad range of scientific principles to solve a crime or legal scenario.
French – Parlez-vous francais? This introductory French course is designed for middle school students with little or no previous
experience in the language. From day one the students will be using the language through a variety of activities ranging from
games to skits. All activities are designed to enhance fluency and proficiency.
Fungus Among Us – You won’t need a green thumb for this class; after all, you’ll be growing mold, not marigolds. It’s a fungusfull world around us; fruit ferment, vegetable rot, and feet itch. This class will require you to collect germs from your toes, shoes,
doorknobs and much more icky and sticky places to produce a bountiful and a glorious gross garden! You will come from this
class asking, how dirty is that knob???
Games Galore! – Teamwork, social skills, creativity, and logical thinking… you’ll need all of those to win in this class. From water
games to thinking games, this class will have creative fun. There will be many challenges both inside and outside the classroom
as we learn the art of “playing nice.”
Genealogy: Who are you? – Students will review genetics and their own personal geneaology journey. In addition, look for
relatives and long-lost family members! Students in this workshop will get involved in an activity in which they can work closely
with their family, identify their ancestors and appreciate their family history.
Got Talent: Music – This is a course in creative writing, listening and reading. Song lyrics from a variety of musical styles will be
explored as poetic texts. Being a musician is not a requirement; all you need is an interest in writing and a love of music. A lyric
writing workshop wil be included.
Introduction to Watercolor – A jumping-off point for beginners: we will learn the basics of watercolor, including mixing, composition, simple “wash” techniques and how to add fine details resulting in a finished landscape or sea-scape. Loose comfortable
clothes are suggested (Some watercolor paints may stain fabrics, so a smock, or a large “throw-away” over shirt is always a good
bet!)
Let’s Fire It Up – Are you tired of peanut butter and jelly? Students will learn basic culinary techniques and terms. This course
will include a cooking project that will fire up the student and quiet the growls of the empty.
Make it Magic – Magic is a performing art that entertains an audience by creating illusions of impossible or supernatural feats,
using purely natural means. Students will learn slight of hand tricks, illusions, and how to make those adorable animals from
balloons.
Marine Biology - Marine Biology is the study of living organisms in the ocean or other marine or brackish bodies of water. Students will learn from an area expert about how marine biology differs form marine ecology and families and genera have some
species that live in the sea and others that live one land. Students will be dissecting shark specimens.
Military History - Military activity has been a constant process over thousands of years, and the essential tactics, strategy, and
goals of military operations have been unchanging throughout history.
Military Science - Students will study the technique, psychology, practice, and other phenomena which constitute war and
armed conflict. Students will have a better understanding for the administration and organization of military units, as well as
of the military as a whole.
Movie Production - Students will learn the process of making a film. Using Microsoft Movie Maker, students will learn how to
blend still photos, clips, music and audio together to make great home videos. Students will gather images from the internet. Come and learn how to add titles, text overlays, special effects and credits to transform your summer production into a blockbuster. Your movie will be ready to show off to family and friends. Students are encouraged to bring their own photos on a CD
or jump drive.
Ooey Gooey Shocking Science - Students will do hands-on science with everyday materials. Come and investigate science concepts including: matter, surface tension, polymers, critical thinking skills, estimations, measurement, cell growth, etc.
Park Ranger Survival Skills - Students will learn from area Park Rangers about what state parks were established for and how
they affect the region around us. Students will learn techniques a person may utilize in order to survive a dangerous situation. These techniques are meant to provide the basic necessities for human like: water, food, and shelter; need to think straight,
signal for help, navigate safely, and avoid unpleasant interactions with animals and plants.
Physics - Emphasis in this class will be placed on using laboratory equipment to perform basic physics experiments. Subjects
included will be mechanics, electricity and magnetism, optics (including lasers and telescopes) and sound. The physics of rocket
flight will be discussed and model rockets will be launched as part of the experiments.
Pottery (Back by Popular Demand) - Classes include hand-building and wheel-throwing techniques using earthen clay, glazing
and learning to work in a clay studio.
Robot Wars - An introduction to the world of robotics, with hands on activities using compressed air, hydraulics, and electric
motors. Also includes a robotics competition to test the students’ teamwork and robot manipulation skills.
Sign Language Level I - Students in this beginning course will receive a wonderful introduction to the fourth most used language
in the United States! Students will learn and practice the manual alphabet, basic nouns, verbs and pronouns. Many other signs,
including, but not limited to categories such as family members, colors, foods and seasons will also be studied.
Song Writing – Students will learn the basics of song writing to include verse, chorus, rhythm, lyrics and song writing tools.
So you want to be an Engineer - Engineering, much like science, is a broad discipline which is often broken down into several
sub-disciplines. Students will learn about the various disciplines of engineering work in our local area such as Civil Engineering,
Mechanical Engineering, Electrical Engineering, and Computer Engineering.
So you want to be a Lawyer - A brief introduction to the American legal system with an emphasis on the components and
participants in a jury trial. The class will end with a mock trial in which students will assume the roles of attorneys, jurors and
witnesses.
So you want to be a Physical Therapist – Are you interested in pursuing a career with rewards of assisting people with health
conditions, disabilities, and pain or movement problems? Physical Therapist provides specifically prescribed treatments and
exercises that improve one’s mobility, relieve pain, and prevent or limit physical disability. In addition, Physical Therapists help
restore, maintain or promote overall fitness and health. Come and join this class for a variety of hands-on activities that will
promote your interest in physical therapy.
So you want to be a Veterinarian - Have you ever thought about being a Veterinarian, often shortened to Vet? A Veterinarian
is a physician for animals and a practitioner of veterinary medicine. Unknown to most, Veterinarians were in the fore-front in
the effort to suppress malaria and yellow fever in the United States, and a veterinarian was the first to note disease caused by
West Nile Virus in New York zoo animals.
Spanish – This introductory Spanish course is designed for middle school students with little or no previous experience in the
language. Students will be using the language through a variety of activities designed to enhance fluency and proficiency.
Weird Science- This science class will include many interesting, weird, and fun hands-on science lab projects in¬cluding Magic
Sand, Plastic Milk, Freezing Point, and more! As we do experiments, we will be learning the science behind how and why they
work. The finished products will be yours to keep!
WALTERS STATE COMMUNITY COLLEGE
2013 TALENTED AND GIFTED PROGRAM
MEDICAL RELEASE AND INFORMATION FORM
As the parent, guardian, or next of kin of:
Student’s Name
I give permission for him/her to receive necessary, routine medical attention from Walters State Community
College while attending the 2013 Talented and Gifted Program (“TAG”). I also give permission for emergency
medical treatment, if necessary. Whom should we contact in case of an emergency?
Name:
Relationship:
Phone:
Name:
Relationship:
Phone:
Does your child have allergies or other health problems we should know about? Please specify:
Is your child taking any medications that emergency medical personnel should be aware of? Please specify:
Is your child allergic to bee stings? Yes No
Has your child ever been a heat casualty? Yes No
Health Insurance Carrier:
Policy Number:
Signature of Parent/Guardian Date
2013 TALENTED AND GIFTED PROGRAM
LIABILITY RELEASE, WAIVER, DISCHARGE AND COVENANT NOT TO SUE
This is a legally binding Release executed by:
Name of Student
,
Street Address
,
City, State, Zip
,
hereinafter referred to as the “Student”, and by,
Name of Parent or Guardian
,
whose address, if different from the Student’s is:
Street Address
,
City, State, Zip
,
hereinafter referred to as “Parent/Guardian”, to Walters State Community College (“College”), 500 South Davy Crockett Parkway,
Morristown, Tennessee 37813-6899.
1.0
1.1
1.2
1.3
2.0
3.0
4.0
We, the undersigned request that the Student be granted permission to participate in the 2013 Talented and Gifted Program (“TAG”), to
be held at the College’s main campus at 500 South Davy Crockett Parkway, Morristown, Tennessee 37813-6899 on the following dates:
Saturday, January 12, 19, 26, February 2, 9 and 16, 2013. In the event of inclement weather, alternative date(s) will be announced at
the applicable time.
Some TAG classes include activities that are more dangerous than others. The Student is not required to participate in any class that
the Student or Parent/Guardian perceives as too risky. TAG classes on the main campus include Chemistry wherein the Student may be
exposed to common laboratory chemicals. Activities in the Physics class will be conducted in a laboratory setting containing laboratory equipment and paraphernalia. The Student in the Physics class may also participate in the launching of a very small rocket from
the campus parking lot. The Student in Biology, A&P Pickled Pigs and So you want to be a Vet may participate in the dissection activities. All of the above named activities involve the use of materials and equipment that may cause bodily harm if improperly used. The
Student will be supervised at all times while engaged in these activities.
In addition to the TAG activities on the main campus, one or more of the scheduled classes may include field trips. Students will be
taken to the sites via a Walters State vehicle or a county school bus; such transportation includes the inherent risks and dangers of any
ground travel.
The College reserves the right to cancel classes, field trips or other activities contained therein or prevent the Student from participating in such classes or class activities if, in the College’s sole judgment, such classes, activities, or participation may seriously endanger
the Student or other Students or otherwise be harmful or inconsistent with the normal practices and philosophy of the College and all
applicable policies of the Tennessee Board of Regents.
In consideration of the Student being permitted to participate in TAG, we do release, waive, forever discharge, and covenant not to sue
the College, its governing board, officers, agents, employees, and any students acting as employees (“Releasees”), from and against
any and all liability for any harm, injury, damage, claims, demands actions, causes of action, costs, expenses of any nature which the
Student may have or which may hereafter accrue to the Student, arising out of or related to any loss, damage, or injury, including but
not limited to suffering and death, that may be sustained by the Student or by any property belonging to me, whether caused by the
negligence or carelessness of the Releasees, or otherwise, while the Student is in, on, upon, or in transit to or from the premises where
TAG, or any adjunct to TAG, occurs or is being conducted.
We have signed this “Release, Waiver, Discharge, and Covenant Not to Sue” in full recognition and appreciation of the dangers, hazards, and risks of such activities, which dangers include but are not limited to those described in Sections 1.1 and 1.2 of this Release,
and which could include serious or even mortal injuries and property damage. We further attest that we have fully discussed the aforementioned risks and hazards, and the Student and the Student’s Parent/Guardian agree that the Student has individually assumed the
risks involved with TAG as witnessed below.
We understand and agree that Releasees do not have medical personnel available at the location of the Student or on the campus. We
understand and agree that Releasees are granted permission to authorize emergency medical treatment, if necessary, and that such action by Releasees shall be subject to the terms of this Agreement. We understand and agree that Releasees assume no responsibility for
any injury or damage which might arise out of or in connection with such authorized emergency medical treatment.
5.0
6.0
7.0
It is our express intent that this Release and hold harmless agreement shall bind the members of the Student’s family, if the Student is
alive, and the Student’s family, estate, heirs, administrators, personal representatives, or assigns, if the Student is deceased, and shall
be deemed as a “Release, Waiver, Discharge and Covenant Not to Sue” the Above-Named Releasees. The Student’s Parent/Guardian
further agrees to save and hold harmless, indemnify, and defend Releasees from any claim by the Student or the Student’s family, arising out of the Student’s participation in TAG.
In signing this Release, the Student and the Student’s Parent/Guardian acknowledge and represent that we have fully informed ourselves of the content of this Release of liability and hold harmless agreement by reading it before we sign it, and that we have reviewed
it and the Student understands what it means and that we sign this document as our free act and deed. No oral representations, statements, or inducements, apart from the foregoing written statement, have been made. We further state that there are no health-related
reasons or problems which preclude or restrict the Student’s participation in TAG, and that the Student has adequate health insurance
necessary to provide for and pay any medical costs that may be attendant as a result of injury to the Student.
We further agree that this Release shall be construed in accordance with the laws of the State of Tennessee. If any term or provision
of this Release shall be held illegal, unenforceable, or in conflict with any law governing this Release, the validity of the remaining
portions shall not be affected thereby.
I, the Student’s Parent/Guardian, further state that I am the Student’s Parent/Guardian, and am fully competent to sign this Agreement; and that
I execute this Release for full, adequate, and complete consideration fully intending for myself, for the Student, and for the Student’s family,
estate, heirs, administrators, personal representatives, or assigns to be bound by the same.
IN WITNESS WHEREOF, we have executed this release this ________day of __________________, 20 _____ .
THIS IS A RELEASE OF LEGAL RIGHTS. READ BEFORE SIGNING.
PARENT OR GUARDIANSTUDENT
Signature of Parent/Guardian
Date
Signature of Student Date
TENNESSEE BOARD OF REGENTS
Walters State Community College
I do hereby authorize Walters State Community College and those acting under its authority to:
a. Record my participation, statements, and appearance on videotape, audiotape, film photography, or any
other medium.
b. Use my name, likeness, voice, and biographical materials in connection with these recordings.
c. Exhibit or distribute such recording in whole or in part without restrictions or limitations for any educational or promotional purpose which Walters State Community College and those acting under its authority deem appropriate. Exhibition or distribution may be through television, home video playback devices,
audio visual library services or unspecified media.
These rights are granted to Walters State Community College and apply throughout the world.
Name:
Address:
Phone No:
Signature:Witness Signature:
Parent / Guardian Signature (if under 18):
THREE WAYS TO PAY FOR 2013 TALENTED AND GIFTED
PAYMENT OPTION 1 - Online
1. Pay online with a credit card (VISA, MASTERCARD or DISCOVER) at www.ws.edu/tag/
2. Print, fill in all requested forms (registration and liability forms) and mail or fax to:
3. Fax: 423-585-2679
Community Education-Talented and Gifted
Walters State Community College
500 S. Davy Crockett Pkwy
Morristown, TN 37813-6899
PAYMENT OPTION 2 - Mail
1. Mail check, or money order and completed registration, signed liability release forms to: Check or money order should be payable to Walters State Community College
Cashier’s Office
Walters State Community College
500 S. Davy Crockett Pkwy
Morristown, TN 37813-6899
PAYMENT OPTION 3 - Walk-In: Pay by Check, Cash, Money Order or Credit Card
(VISA, MASTERCARD or DISCOVER)
1. Come to any Walters State Community College campus location
a. Morristown: Cashiers’ Office, 1st floor Student Services Center
b. Sevierville: Cashiers’ Office, Maples-Marshall Hall, Room 100
c. Greeneville: Cashiers’ Office, Main Entrance, 1st floor, Room 103
d. Claiborne: Cashiers’ Office, Room 038
2. Leave completed registration, and liability forms at Cashier’s Office
TAG - Checklist
Registration/Student Preference Survey
Registration Fee
Liability Release, Waiver, Discharge And Covenant Not To Sue
Medical Release And Information Form
All Documents Are Complete And Signed by Legal Guardian