Thank you for registering for COE Summer Programs. 1. Complete and submit this form 2. Return to your cart to complete your registration RM_StatsCreate or Log In to AccountAlready have an account? Please log in first before completing the registration form: Log in to your existing account CREATE NEW ACCOUNT Email *Username *Password *Password must be at least 7 characters long.Enter password again *Password must be at least 7 characters long.Parent or Guardian Contact InformationPrimary Parent: First Name *Primary Parent: Last Name *Relationship to Student *MotherFatherGrandmotherGrandfatherGuardianOtherPrimary Phone *Please list a phone number where we can reach you during the program.Alternate PhonePlease list a phone number where we can reach you during the program. Second Parent: First NameSecond Parent: Last NameRelationship to StudentMotherFatherGrandmotherGrandfatherGuardianOtherPrimary PhonePlease list a phone number where we can reach you during the program.Alternate PhonePlease list a phone number where we can reach you during the program.Has your child previously enrolled in COE (CRDG) Summer Programs? * Yes No First Name *Last Name *NicknameThis name will be used on forms and student IDGender (Pronouns)Select an optionHe/HimShe/HerThey/ThemOther/Prefer not to sayMailing Address Address Line 1 * Address Line 2 City * State or Region * Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas, The Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, The Democratic Republic Of The Cook Islands Costa Rica Cote D'ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia, The Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and the McDonald Islands Holy See Honduras Hong Kong Hungary Iceland India Indonesia Iraq Iran Ireland Isle Of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Korea, Republic Of Kosovo Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Macedonia, The Former Yugoslav Republic Of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States Of Moldova, Republic Of Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territories Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and The Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania, United Republic Of Thailand Timor-leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Venezuela Vietnam Virgin Islands, British Virgin Islands, U.S. Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Country * Zip * For U.S. residents, course information will be mailed to the address provided. For international students, course information will be emailed.Current School *Grade (next school year) *123456789OtherShirt Size *Youth SmallYouth MediumYouth LargeAdult SmallAdult MediumAdult LargeAdult XLAdult XXLStudents will receive 1 free Summer Programs shirt on their first day of class. Students may exchange new, unworn shirts for a different size, pending availability.Can your child sign out and leave campus on their own? * Yes [Once signed out, student is not the responsibility of COESP] No [List people authorized to pick up the student]Authorized names must match an ID, Enter first and last names, separated by a comma.If you want your child to be allowed to leave on their own only on certain days, select NO above. Then, on authorized days, let the office know your plans at least 24 hrs in advance. Illnesses or Other Conditions * No Yes (list medical issues that may affect participation)Food Allergies or Dietary Restrictions * No Yes (list any that may affect participation)In case of emergency, may we take your child to emergency care? * Yes No Alternate Emergency Contacts (if parents cannot be reached)Emergency #1 First NameEmergency #1 Last NameRelationshipMotherFatherGrandmotherGrandfatherGuardianUncleAuntFriendOtherPhone Number Emergency #2 First NameEmergency #2 Last NameRelationshipMotherFatherGrandmotherGrandfatherGuardianUncleAuntFriendOtherPhone NumberDIGITAL DEVICE, NETWORK, AND ACCOUNTS AGREEMENT FORM A copy of this form will be emailed to you with your registration confirmation. Please review this form in detail with your child. Acceptable Use Policy (AUP) The College of Education (COE) Summer Programs (SP) is designed for students entering grades 1–9 and takes place on the campus of a higher education research and enrichment environment. COE SP provides students with access to Internet capable digital devices, as well as other technologies with the goal of fostering a 21st century learning environment. This form outlines policies and guidelines regarding digital devices, network usage, and account management. All students attending COE SP and their parents/guardians shall agree to abide by the established policies. Digital Devices COE SP may provide access to digital devices for use in enhancing and promoting a technological learning environment. These devices are to be used for educational purposes only and users are expected to treat these devices with extreme care and caution. Users should immediately report any malfunction, damage, or loss to the teacher. Students (or their parents/guardians) may be held liable for any financial losses incurred from user-inflicted damages to any program issues device. Network COE SP may provide users with the privilege of accessing our secured wireless network for Internet usage. As such, users should respect and not attempt to circumvent and manipulate Internet filters that are put in place for the security and protection of the users. Users should take a precautionary approach when dealing with files on the Internet by not opening and distributing links and files of untrusted origin and by not downloading and running any executable programs without the explicit permission of the staff. Activities that occur on the network may be monitored by the administrator. Additionally, users must agree to uphold proper etiquette when conducting themselves on the network by displaying respect, courtesy, and integrity when collaborating with and communicating to all other users. If a user is found to have violated network policies, the privilege of network access may be revoked. Accounts Users may be given specific accounts that will enable them access to the devices and network of COE SP. Users should safeguard account credentials, which include, but are not limited to, user IDs and passwords; personal information such as social media accounts, phone numbers, addresses, social security numbers; and any type of information that may act as personal identifiers. Users agree to be the sole user of the account assigned to them and agree to take all preventive and precautionary measures available to ensure the integrity of user information. All of our activities are focused on educational themes with staff guidance and with the avoidance of inappropriate material in mind. When using e-mail, cloud-based services, as well as engaging in other online activities, students agree to follow these policies: Accept personal responsibility and obey all policies as outlined by the AUP. Only access the Internet using the COESP provided WIFI network. Not access other wired or wireless networks using another username and password. Conduct themselves in an ethical and orderly manner. Refrain from sending or displaying offensive messages, images, or videos. Not use obscene language in communications. Prevent cyberbullying by not harassing, insulting, or attacking others. Not misuse program-owned digital devices, accounts, or networks. Notify a teacher or program administrator immediately about any improper use. Respect the privacy of other users by not copying their user IDs, passwords, or credentials. Not impersonate someone by using another’s login/password. Not tamper with others' files saved to shared devices. Adamantly protect their personal passwords. Exercise good personal judgment in avoiding inappropriate materials. Observe all laws relating to copyright, trademark, export, and intellectual property rights. Not engage in activities that compromise institutional systems or network performance for others. By typing my name and clicking Submit at the end of this form, I acknowledge that my child and I both understand and agree to the policies and responsibilities governing the use of the Internet and electronic devices in the COE Summer Programs at the University of Hawai‘i at Manoa. I consent that my typed name constitutes my electronic signature, and this electronic signature signifies my intent to be legally bound, just as if I manually signed a paper document in ink. Digital Signature *LIABILITY AND RELEASE FORM ASSUMPTION OF RISK: While precautions are taken to ensure proper supervision and safety during your child’s participation in COE Summer Programs, I understand and acknowledge there are dangers and risks involved in my child’s participation in COE Summer Programs including, but not limited to, illness, personal or bodily injury, death, economic and property damage, emotional stress, and other losses, damages, or injuries. I acknowledge that there may be other injuries or damages not readily foreseeable at this time. I understand and acknowledge that my child's participation is voluntary. I fully accept and assume all risks of the Injuries/Damages resulting from my child’s participation in the COE Summer Programs. TRANSPORTATION: Transportation may be provided by Summer Programs staff or by ground carriers contracted by Summer Programs. I authorize my child to ride on provided transportation and will not hold the University of Hawaii, College of Education, or COE Summer Programs liable for any accidents, injuries, or damages to persons or property. MEDIA RELEASE: I authorize and give full right and permission to the University of Hawaii, College of Education, and COE Summer Programs (collectively, the “Released Parties”), to take and use my child’s name, image, likeness, appearance, voice, and original work created or recorded during my child’s participation in any activities relating to the COE Summer Programs, in any and all forms captured by the Released Parties, including photographs, video, and sound recordings (collectively the “Recordings”): (a) for advertising, publicity, trade or any other legitimate purpose, including any educational, institutional, scientific, fundraising or informational purposes, (b) in perpetuity, (d) without compensation to me/my child, (e) in any manner or media, now known or hereafter developed or invented, including use on social media sites and web pages accessible to the general public, and (f) alone or in combination with other Recordings. I waive any right I/my child may have to inspect and/or approve the finished product of the Recordings or the use to which it may be applied. I acknowledge and agree that all right, title, and interest in the Recordings belong solely to the Released Parties. VIDEO DISTRIBUTION: I will not distribute any of the COE Summer Programs videos or other media distributed solely to COE Summer Programs families and intended for personal use. This includes, but is not limited to, duplicating copies for other than personal use, posting all or part of a video online or on social media, or any profit generating purposes. RELEASE: I waive, release, and discharge the University of Hawai’i, College of Education, and COE Summer Programs, its trustees, officers, employees, and agents from any and all claims, demands, actions, rights, and causes of action for any injuries or damages, known or unknown, related to, arising from, or traceable either directly or indirectly to my child’s participation in COE Summer Programs By typing my name and clicking Submit at the end of this form, I confirm that I am a legal parent or guardian for this child, acknowledge that I have read, understand, and agree to the stated terms and conditions, and grant consent for my child to participate in COE Summer Programs. I consent that my typed name constitutes my electronic signature, and this electronic signature signifies my intent to be legally bound, just as if I manually signed a paper document in ink. Digital Signature *How did you hear about CRDG Summer Programs COE SP Website Search Engine Social Media Email From Friends or Family Hawaii Parent magazine Honolulu Summer Camp website University Laboratory School University of Hawaiʻi System OtherAnnual household income before taxes Less than $25,000 $25,000 to $34,999 $35,000 to $49,999 $50,000 to $74,999 $75,000 to $99,999 $100,000 to $149,999 $150,000 or more Note: It looks like JavaScript is disabled in your browser. Some elements of this form may require JavaScript to work properly. If you have trouble submitting the form, try enabling JavaScript momentarily and resubmit. JavaScript settings are usually found in Browser Settings or Browser Developer menu. Skip back to main navigation