Summer Academy Permission Form - Hendricks CareerTek

Academy Permission Form

Phone
This field is for validation purposes and should be left unchanged.
Student Name*
First Last
Parent/Guardian Name*
First Last
Parent/Guardian CELL phone number*
I give permission for my child to participate in the 2026 Summer Academy. Location will depend on which Academy my child participates in. Hendricks CareerTek 625 3rd Street, Suite 200, Beloit Blackhawk Technical College 6004 S Cty Rd G, Janesville Geronimo Properties within walking distance Various locations with Welty Environmental Center Scot Forge, Clinton Beloit Hospital Ironworks Campus Beloit YMCA As a parent or guardian, I understand that Academy staff and volunteers will do everything possible to prevent any accidents over which they have control. However, I fully understand that participation in the program activities may involve some inherent risks to students regardless of all feasible safety measures that may be taken. As a voluntary participant in the program, I agree to accept responsibility for any loss, damage, or injury to my child that occurs during my child’s participation that is not the result of fraud, willful injury to a person or property, or the willful or negligent violation of a law by an employee or agent of Blackhawk Technical College or Hendricks CareerTek. I further authorize Academy staff to obtain emergency care for my child when it is deemed reasonably necessary for my child’s health or safety. I understand that Blackhawk Technical College or Hendricks CareerTek does not provide medical insurance nor assume any liability for injuries incurred traveling to, from and during the activity. By execution of this agreement, the participant assumes full risk and responsibility for any injuries or damages, which may occur to the participant. Lastly, I understand that if my child’s arrangements change it is my responsibility to notify the Hendricks CareerTek staff immediately.*
Permission to participate
I give permission for my child to participate in the 2026 Summer Academy. Location will depend on which Academy my child participates in.

Hendricks CareerTek 625 3rd Street, Suite 200, Beloit

Blackhawk Technical College 6004 S Cty Rd G, Janesville

Geronimo Properties within walking distance

Various locations with Welty Environmental Center

Scot Forge, Clinton

Beloit Hospital

Ironworks Campus

Beloit YMCA

As a parent or guardian, I understand that Academy staff and volunteers will do everything possible to prevent any accidents over which they have control. However,
I fully understand that participation in the program activities may involve some inherent risks to students regardless of all feasible safety measures that may be taken.
As a voluntary participant in the program, I agree to accept responsibility for any loss, damage, or injury to my child that occurs during my child’s participation that is not the result of fraud, willful injury to a person or property, or the willful or negligent violation of a law by an employee or agent of Blackhawk Technical College or Hendricks CareerTek.
I further authorize Academy staff to obtain emergency care for my child when it is deemed reasonably necessary for my child’s health or safety.
I understand that Blackhawk Technical College or Hendricks CareerTek does not provide medical insurance nor assume any liability for injuries incurred traveling to, from and during the activity.
By execution of this agreement, the participant assumes full risk and responsibility for any injuries or damages, which may occur to the participant.
Lastly, I understand that if my child’s arrangements change it is my responsibility to notify the Hendricks CareerTek staff immediately.
I understand that my child might leave the Academy site and I grant permission for my child to travel with the Academy group. Certain Academies may have a walking tour scheduled. The group will be supervised at all times by HCT staff.*
Permission to Travel
I understand that my child might leave the Academy site and I grant permission for my child to
travel with the Academy group. Certain Academies may have a walking tour scheduled. The
group will be supervised at all times by HCT staff.
Photo Release*
I grant permission to photograph my student for promotional and/or educational purposes
- YES
- NO
Please indicate if your child has any medical condition/concerns/food allergy that Hendricks CareerTek staff should be aware of during the course of this field trip:
Parent Signature*
Parent's Name*
Enter Today's Date*
MM slash DD slash YYYY
Student Signature if 18 and over
Student's Name*
Enter Today's Date*
MM slash DD slash YYYY
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