Fort St. Joseph Archaeological Project

Institute for Intercultural and Anthropological Studies
Western Michigan University
Kalamazoo MI 49008-5494 USA
(269) 387-2505

Summer Camp Forms - Minors

Camp Attending (required)

(choose one/check box)

Waiver, Release, and Indemnification Agreement 

have requested permission and have agreed to allow my child (the "Student") to participate in the archaeological dig led by Western Michigan University ("WMU") on the 15 acre site adjacent to and including the Fort St. Joseph memorial boulder / marker owned by the City of Niles, Michigan ("City"). The Student is not required to participate in this Dig. Participation is wholly voluntary on the part of the Student and me. In consideration of the City's and WMU's agreement to permit the Student to participate in this Dig, the receipt and sufficiency of which is hereby acknowledged, I agree as follows: 

  1. I represent and warrant that the Student will be covered throughout the Dig by a policy of comprehensive health and accident insurance which provides coverage for illnesses or injuries sustained or experienced. I hereby release and discharge the City and WMU from all responsibility and liability for any injuries (including death), illnesses, medical bills, charges, or expenses incurred while on the Dig or in transit to or from the Dig. 
  2. I, individually, and on behalf of my heirs, successors, assigns, and personal representatives, hereby release and forever discharge the City and its employees, agents, servants, officers, trustees, and representatives (in their official and individual capacities) and WMU from any and all liability, loss or damage that they or any of them incur or sustain as a result of any claims, demands, actions, causes of action, judgments, costs, or expenses, including attorney’s fees, which arise out of, result from, occur during, or are connected in any manner with the Student's participation in the Dig and/or any travel incident thereto. 
  3. I, individually, and on behalf of my heirs, successors, assigns, and personal representatives, hereby agree to indemnify, defend, and hold harmless the City and its employees, agents, servants, officers, trustees, and representatives (in their official and individual capacities) and WMU from any and all liability, loss, or damage that they or any of them incur or sustain as a result of any claims, demands, actions, causes of action, judgments, costs, or expenses, including attorney's fees, which arise out of, occur during, or are in any way connected with the Student's participation in the Dig or any travel incident thereto.
  4. I agree that this Waiver, Release, and Indemnification Agreement is to be construed under the laws of the State of Michigan; and that if any portion hereof is held invalid, the balance hereof shall, notwithstanding, continue in full legal force and effect. In signing this document, I hereby acknowledge that I have read this entire document, that I understand it's terms, that by signing it, I am giving up substantial legal rights I might otherwise have, and that I have signed it knowingly and voluntarily.

Medical Release and Authorization

As Parent and/or Guardian of the named student, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical impairment, or other undue pain, suffering or discomfort, if delayed.

Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named student. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me.

Permission is also granted to Western Michigan University and its affiliates including staff, teachers, and students to provide the needed emergency treatment prior to the child’s admission to the medical facility.

This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.

Please make us aware of any health-related information regarding your child about which you feel staff or faculty should be aware. List all allergies and any medications your student is taking. (Note: You are responsible for administering all medications, etc., for your child.)

Drop-Off and Pick-Up Agreement for Minor Students

Fort St. Joseph Archaeological Project’s designated drop-off and pick-up locations for the archaeology summer camps will be the Niles District Library and the Fort St. Joseph site (see red stars). In general, camp participants should be dropped-off at the Niles District Library and picked-up from the Fort St. Joseph site (weather permitting). Transportation from the library to the site will take place around 11:45 a.m. and will be provided by the City of Niles Dial-A-Ride Transportation (DART).

Please indicate your drop-off and pickup arrangements below. Each student must have a drop-off/pick-up agreement on file with the Fort St. Joseph Archaeological Project, Western Michigan University, and the Niles History Center. If your plans change during the week, please let us know so that we can have you fill out a new form.

FSJ Pick Up and Drop Off Agreement

Please choose one (required)

Archaeological Project Participant Code of Conduct

All participants are representatives of their Program, their schools, the University, and the community.  As such, they are expected to conduct themselves in an appropriate manner, particularly while on campus, on site, and in the community. Please read the following Code of Conduct carefully.  It must be read before enrolling in the Fort St. Joseph Archaeological Project’s summer camp program or the archaeological field school. 

  • I will not leave WMU and Niles-owned and/or controlled property unattended during the program/school.
  • I will consider the privacy wishes and concerns of others before using cameras, video recorders, or any type of recording device.  I will not use any type of recording device in showers, locker rooms, rest rooms, bedrooms, or other areas where participants may expect privacy.
  • I will make every effort to be present and on time for each session. I will make sure that I have the appropriate materials that I need, and I will be ready to work at the designated time.
  • I will put away cell phones, laptops, tablets, and mp3 players while in class, unless their use is approved by instructor.
  • I will treat all university and community property with respect. 
  • I will clean up after myself and bring all trash to the receptacles.
  • I will act appropriately and courteously at all times while in the program. I will use school appropriate language and behavior, keeping my hands, feet, and other objects to myself. 
  • I will address other campers, students, instructors, and staff respectfully. I will listen with the same respect, understanding that the opinions of others are equally valid. I will offer only positive comments and avoid negative stereotypes.
  • I will be tolerant of others especially where it involves race, religion, sexual orientation, disability status, gender, age, or ethnic background.
  • I will follow rules set forth by the university and instructor. 

Media, Photo, and Video Authorization

I understand that during the course of my child’s participation in in the Fort St. Joseph Archaeology Summer Camp, that the Fort St. Joseph Archaeological Project (the "Project”) and/or those acting with the Project’s permission or authority, may capture my child’s name, likeness, image, or voice in photographic, audio, video, digital or other recording forms (“Recordings”). I give my permission for the Project to use those recordings or works produced by my child (e.g., art work) for promotional, commercial, informational, and educational purposes in any and all media (including the Internet) now existing or hereafter devised, for any purpose consistent with the Project’s mission. I understand that I will not have an opportunity to review or approve uses of the Recordings or Works. 
 
I recognize that the Project, Western Michigan University, and the City of Niles hold the copyright in all Recordings. I understand that neither my child nor I will receive payment or any other compensation for the taking or use of any Recordings or Works created as a result of my child’s participation in the Project. I release, indemnify and hold harmless the Project, Western Michigan University, and the City of Niles from and against all liability, actions, debts, claims and demands of every kind whatsoever to the taking or use of the Recordings or Works of my child.
 
Media Release Decision (required)
By selecting Yes below you are giving permission to the Project, Western Michigan University, and the City of Niles to take or use your child's name, likeness, image, or voice in any form or to use work produced by your child for any reason unless necessary for the administration of the Project while your child is participating in the Program. Selecting no does not grant permission for that.

Authorization Signatures

Signature Relationship to Participant (required)